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 $208.93 Median $218.78 Typical High $389.05 | Professional | None | $208.93 | $218.78 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $251.19 Typical High $316.23 | Professional | None | $138.04 | $251.19 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $933.25 Typical High $1,348.96 | Facility | None | $537.03 | $933.25 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $371.54 Typical High $645.65 | Professional | None | $204.17 | $371.54 | $645.65 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,691.53 | Facility | None | $660.69 | $776.25 | $2,691.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $162.18 Median $302.00 Typical High $602.56 | Professional | None | $162.18 | $302.00 | $602.56 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,691.53 | Facility | None | $660.69 | $851.14 | $2,691.53 |
United Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $588.84 | Professional | None | $194.98 | $331.13 | $588.84 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
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 $104.71 Median $109.65 Typical High $190.55 | Professional | 52 · Reduced service | $104.71 | $109.65 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $43.65 Typical High $77.62 | Professional | 53 · Discontinued | $41.69 | $43.65 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $162.18 Typical High $288.40 | Professional | 54 · Surgery only | $154.88 | $162.18 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $32.36 Typical High $57.54 | Professional | 55 · Aftercare only | $30.90 | $32.36 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $21.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.89 | $21.88 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $151.36 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $144.54 | $151.36 | $269.15 |
Where New Hampshire sits
The same service costs 4.2 times more in Alaska than in Virginia. 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· 22nd of 51
$282
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.