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 $338.84 Median $389.05 Typical High $537.03 | Professional | None | $338.84 | $389.05 | $537.03 |
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 $467.74 Typical High $812.83 | Professional | None | $302.00 | $467.74 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $870.96 Typical High $1,513.56 | Professional | 50 · Both sides | $512.86 | $870.96 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $575.44 Typical High $741.31 | Facility | None | $446.68 | $575.44 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,071.52 | Professional | None | $436.52 | $676.08 | $1,071.52 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $416.87 Median $707.95 Typical High $1,412.54 | Professional | None | $416.87 | $707.95 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $1,174.90 | Professional | None | $389.05 | $562.34 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
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 $169.82 Median $194.98 Typical High $316.23 | Professional | 52 · Reduced service | $169.82 | $194.98 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $79.43 Typical High $128.82 | Professional | 53 · Discontinued | $69.18 | $79.43 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $295.12 Typical High $478.63 | Professional | 54 · Surgery only | $257.04 | $295.12 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $95.50 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.90 Typical High $63.10 | Professional | 56 · Pre-op care only | $33.88 | $38.90 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $275.42 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $239.88 | $275.42 | $446.68 |
Where New Hampshire sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 14th of 51
$562
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.