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 $158.49 Median $199.53 Typical High $9,772.37 | Facility | None | $158.49 | $199.53 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $457.09 | Professional | None | $158.49 | $199.53 | $457.09 |
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 $162.18 Median $245.47 Typical High $467.74 | Professional | None | $162.18 | $245.47 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $288.40 Typical High $575.44 | Facility | None | $218.78 | $288.40 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $691.83 | Professional | None | $194.98 | $302.00 | $691.83 |
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 $223.87 Median $380.19 Typical High $741.31 | Professional | None | $223.87 | $380.19 | $741.31 |
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 $213.80 Median $309.03 Typical High $575.44 | Professional | None | $213.80 | $309.03 | $575.44 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
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 $79.43 Median $95.50 Typical High $117.49 | Professional | 52 · Reduced service | $79.43 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $38.90 Typical High $46.77 | Professional | 53 · Discontinued | $31.62 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $144.54 Typical High $177.83 | Professional | 54 · Surgery only | $120.23 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $28.84 Typical High $35.48 | Professional | 55 · Aftercare only | $23.99 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $19.05 Typical High $23.44 | Professional | 56 · Pre-op care only | $15.85 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $134.90 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $112.20 | $134.90 | $165.96 |
Where New Hampshire sits
The same service costs 3.9 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.