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 $138.04 Typical High $6,025.60 | Facility | None | $100.00 | $138.04 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $281.84 | Professional | None | $100.00 | $138.04 | $281.84 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
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 $100.00 Median $162.18 Typical High $302.00 | Professional | None | $100.00 | $162.18 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $213.80 Typical High $575.44 | Facility | None | $162.18 | $213.80 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $218.78 Typical High $467.74 | Professional | None | $120.23 | $218.78 | $467.74 |
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 $141.25 Median $245.47 Typical High $501.19 | Professional | None | $141.25 | $245.47 | $501.19 |
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 $138.04 Median $218.78 Typical High $407.38 | Professional | None | $138.04 | $218.78 | $407.38 |
Well Sense Setting Facility Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
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 $48.98 Median $60.26 Typical High $83.18 | Professional | 52 · Reduced service | $48.98 | $60.26 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $23.99 Typical High $33.11 | Professional | 53 · Discontinued | $19.95 | $23.99 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $91.20 Typical High $123.03 | Professional | 54 · Surgery only | $74.13 | $91.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $18.20 Typical High $24.55 | Professional | 55 · Aftercare only | $14.79 | $18.20 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $16.60 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $85.11 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $69.18 | $85.11 | $114.82 |
Where New Hampshire sits
The same service costs 3.5 times more in Alaska than in Florida. 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
$200
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.