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 $141.25 Median $371.54 Typical High $8,912.51 | Facility | None | $141.25 | $371.54 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $190.55 Typical High $467.74 | Professional | None | $141.25 | $190.55 | $467.74 |
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 $154.88 Median $234.42 Typical High $446.68 | Professional | None | $154.88 | $234.42 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,412.54 Typical High $1,778.28 | Facility | None | $537.03 | $1,412.54 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $691.83 | Professional | None | $181.97 | $309.03 | $691.83 |
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 $199.53 Median $371.54 Typical High $724.44 | Professional | None | $199.53 | $371.54 | $724.44 |
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 $302.00 Typical High $562.34 | Professional | None | $199.53 | $302.00 | $562.34 |
Well Sense Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
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 $70.79 Median $87.10 Typical High $114.82 | Professional | 52 · Reduced service | $70.79 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $34.67 Typical High $45.71 | Professional | 53 · Discontinued | $28.18 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $128.82 Typical High $173.78 | Professional | 54 · Surgery only | $107.15 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $25.70 Typical High $34.67 | Professional | 55 · Aftercare only | $21.38 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $17.38 Typical High $22.91 | Professional | 56 · Pre-op care only | $14.13 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $120.23 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $100.00 | $120.23 | $162.18 |
Where New Hampshire sits
The same service costs 4.6 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
$295
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.