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 $107.15 Median $208.93 Typical High $8,912.51 | Facility | None | $107.15 | $208.93 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $316.23 | Professional | None | $117.49 | $181.97 | $316.23 |
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 $120.23 Median $194.98 Typical High $302.00 | Professional | None | $120.23 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $204.17 Median $338.84 Typical High $575.44 | Professional | 50 · Both sides | $204.17 | $338.84 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $257.04 Typical High $323.59 | Facility | None | $100.00 | $257.04 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $537.03 | Professional | None | $177.83 | $263.03 | $537.03 |
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 $147.91 Median $275.42 Typical High $616.60 | Professional | None | $147.91 | $275.42 | $616.60 |
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 $158.49 Median $257.04 Typical High $562.34 | Professional | None | $158.49 | $257.04 | $562.34 |
Well Sense Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
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 $67.61 Median $67.61 Typical High $104.71 | Professional | 52 · Reduced service | $67.61 | $67.61 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $41.69 | Professional | 53 · Discontinued | $26.92 | $26.92 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $100.00 Typical High $158.49 | Professional | 54 · Surgery only | $100.00 | $100.00 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $31.62 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $93.33 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $93.33 | $93.33 | $147.91 |
Where New Hampshire sits
The same service costs 4.1 times more in Alaska 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· 18th of 51
$229
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.