How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $398.11 | Professional | None | $281.84 | $389.05 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $524.81 Typical High $891.25 | Professional | None | $302.00 | $524.81 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $758.58 Typical High $1,000.00 | Facility | None | $562.34 | $758.58 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,122.02 | Professional | None | $398.11 | $645.65 | $1,122.02 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $1,202.26 | Professional | None | $338.84 | $602.56 | $1,202.26 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $954.99 | Professional | None | $346.74 | $524.81 | $954.99 |
Well Sense Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $141.25 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $77.62 Typical High $79.43 | Professional | 53 · Discontinued | $56.23 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $288.40 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $42.66 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $38.90 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.18 | $38.90 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $269.15 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $199.53 | $269.15 | $275.42 |
Where New Hampshire sits
The same service costs 4.3 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New Hampshire· 18th of 51
$525
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.