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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $177.83 | Professional | None | $117.49 | $158.49 | $177.83 |
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 $102.33 Median $154.88 Typical High $213.80 | Professional | None | $102.33 | $154.88 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $199.53 Typical High $575.44 | Facility | None | $151.36 | $199.53 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $363.08 | Professional | None | $147.91 | $204.17 | $363.08 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $371.54 | Professional | None | $117.49 | $199.53 | $371.54 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $123.03 Median $194.98 Typical High $323.59 | Professional | None | $123.03 | $194.98 | $323.59 |
Well Sense Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
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 $57.54 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $57.54 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $23.44 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $117.49 Typical High $120.23 | Professional | 54 · Surgery only | $87.10 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $23.44 Typical High $23.99 | Professional | 55 · Aftercare only | $17.38 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $11.75 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $109.65 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $81.28 | $109.65 | $112.20 |
Where New Hampshire sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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· 20th of 51
$174
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.