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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,000.00 | Professional | None | $851.14 | $1,000.00 | $1,000.00 |
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 $1,122.02 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,949.84 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $933.25 Typical High $1,348.96 | Facility | None | $660.69 | $933.25 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,513.56 | $2,884.03 |
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 $1,023.29 Median $1,445.44 Typical High $2,754.23 | Professional | None | $1,023.29 | $1,445.44 | $2,754.23 |
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 $977.24 Median $1,288.25 Typical High $2,344.23 | Professional | None | $977.24 | $1,288.25 | $2,344.23 |
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 $426.58 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $426.58 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $169.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $630.96 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $85.11 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $588.84 | $691.83 | $691.83 |
Where New Hampshire sits
The same service costs 22.4 times more in Alaska than in Texas. 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· 13th of 51
$1,514
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.