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 $128.82 Median $169.82 Typical High $8,912.51 | Facility | None | $128.82 | $169.82 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $371.54 | Professional | None | $128.82 | $169.82 | $371.54 |
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 $138.04 Median $204.17 Typical High $398.11 | Professional | None | $138.04 | $204.17 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $263.03 Typical High $575.44 | Facility | None | $199.53 | $263.03 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $602.56 | Professional | None | $165.96 | $263.03 | $602.56 |
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 $181.97 Median $323.59 Typical High $630.96 | Professional | None | $181.97 | $323.59 | $630.96 |
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 $177.83 Median $269.15 Typical High $501.19 | Professional | None | $177.83 | $269.15 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
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 $64.57 Median $77.62 Typical High $102.33 | Professional | 52 · Reduced service | $64.57 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $31.62 Typical High $40.74 | Professional | 53 · Discontinued | $25.70 | $31.62 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $117.49 Typical High $151.36 | Professional | 54 · Surgery only | $97.72 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.44 Typical High $30.20 | Professional | 55 · Aftercare only | $19.50 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $15.49 Typical High $20.42 | Professional | 56 · Pre-op care only | $12.88 | $15.49 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $109.65 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $91.20 | $109.65 | $141.25 |
Where New Hampshire sits
The same service costs 4.0 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· 14th of 51
$257
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.