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 $263.03 Median $436.52 Typical High $616.60 | Professional | None | $263.03 | $436.52 | $616.60 |
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 $213.80 Median $436.52 Typical High $691.83 | Professional | None | $213.80 | $436.52 | $691.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $660.69 Typical High $1,288.25 | Professional | 50 · Both sides | $436.52 | $660.69 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $331.13 Typical High $436.52 | Facility | None | $100.00 | $331.13 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $616.60 Typical High $1,071.52 | Professional | None | $302.00 | $616.60 | $1,071.52 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $338.84 Median $602.56 Typical High $1,318.26 | Professional | None | $338.84 | $602.56 | $1,318.26 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $331.13 Median $588.84 Typical High $1,258.93 | Professional | None | $331.13 | $588.84 | $1,258.93 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
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 $131.83 Median $218.78 Typical High $309.03 | Professional | 52 · Reduced service | $131.83 | $218.78 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $87.10 Typical High $123.03 | Professional | 53 · Discontinued | $52.48 | $87.10 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $331.13 Typical High $467.74 | Professional | 54 · Surgery only | $199.53 | $331.13 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $66.07 Typical High $93.33 | Professional | 55 · Aftercare only | $39.81 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $43.65 Typical High $61.66 | Professional | 56 · Pre-op care only | $26.30 | $43.65 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $309.03 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $186.21 | $309.03 | $436.52 |
Where New Hampshire sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$447
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.