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 $138.04 Median $177.83 Typical High $9,772.37 | Facility | None | $138.04 | $177.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $177.83 Typical High $398.11 | Professional | None | $138.04 | $177.83 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $213.80 | Professional | None | $83.18 | $131.83 | $213.80 |
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 $144.54 Median $218.78 Typical High $416.87 | Professional | None | $144.54 | $218.78 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $575.44 | Facility | None | $204.17 | $269.15 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $275.42 Typical High $630.96 | Professional | None | $173.78 | $275.42 | $630.96 |
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 $346.74 Typical High $660.69 | Professional | None | $199.53 | $346.74 | $660.69 |
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 $190.55 Median $281.84 Typical High $524.81 | Professional | None | $190.55 | $281.84 | $524.81 |
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 $69.18 Median $85.11 Typical High $104.71 | Professional | 52 · Reduced service | $69.18 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $28.18 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $125.89 Typical High $158.49 | Professional | 54 · Surgery only | $104.71 | $125.89 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $25.70 Typical High $31.62 | Professional | 55 · Aftercare only | $20.89 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $16.98 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.80 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $117.49 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $97.72 | $117.49 | $147.91 |
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
$269
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.