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 $100.00 Median $147.91 Typical High $8,912.51 | Facility | None | $100.00 | $147.91 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $288.40 | Professional | None | $100.00 | $147.91 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $416.87 Typical High $575.44 | Professional | None | $67.61 | $416.87 | $575.44 |
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 $102.33 Median $173.78 Typical High $323.59 | Professional | None | $102.33 | $173.78 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $239.88 Typical High $575.44 | Facility | None | $181.97 | $239.88 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $234.42 Typical High $489.78 | Professional | None | $128.82 | $234.42 | $489.78 |
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 $144.54 Median $263.03 Typical High $537.03 | Professional | None | $144.54 | $263.03 | $537.03 |
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 $141.25 Median $234.42 Typical High $426.58 | Professional | None | $141.25 | $234.42 | $426.58 |
Well Sense Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
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 $50.12 Median $64.57 Typical High $89.13 | Professional | 52 · Reduced service | $50.12 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $35.48 | Professional | 53 · Discontinued | $20.42 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $95.50 Typical High $131.83 | Professional | 54 · Surgery only | $75.86 | $95.50 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $26.92 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.88 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.00 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $89.13 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $70.79 | $89.13 | $123.03 |
Where New Hampshire sits
The same service costs 3.8 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· 15th of 51
$209
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.