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 $162.18 Median $281.84 Typical High $512.86 | Professional | None | $162.18 | $281.84 | $512.86 |
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 $134.90 Median $275.42 Typical High $407.38 | Professional | None | $134.90 | $275.42 | $407.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $275.42 Median $416.87 Typical High $794.33 | Professional | 50 · Both sides | $275.42 | $416.87 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $407.38 Typical High $575.44 | Facility | None | $309.03 | $407.38 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $389.05 Typical High $676.08 | Professional | None | $194.98 | $389.05 | $676.08 |
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 $204.17 Median $380.19 Typical High $891.25 | Professional | None | $204.17 | $380.19 | $891.25 |
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 $199.53 Median $380.19 Typical High $812.83 | Professional | None | $199.53 | $380.19 | $812.83 |
Well Sense Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
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 $79.43 Median $141.25 Typical High $190.55 | Professional | 52 · Reduced service | $79.43 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $56.23 Typical High $75.86 | Professional | 53 · Discontinued | $32.36 | $56.23 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $208.93 Typical High $288.40 | Professional | 54 · Surgery only | $120.23 | $208.93 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $41.69 Typical High $57.54 | Professional | 55 · Aftercare only | $23.99 | $41.69 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $28.18 Typical High $38.02 | Professional | 56 · Pre-op care only | $16.22 | $28.18 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $194.98 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $112.20 | $194.98 | $269.15 |
Where New Hampshire sits
The same service costs 3.8 times more in Wyoming 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· 21st of 51
$302
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.