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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $575.44 | Professional | None | $204.17 | $251.19 | $575.44 |
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 $199.53 Median $302.00 Typical High $575.44 | Professional | None | $199.53 | $302.00 | $575.44 |
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 $245.47 Median $380.19 Typical High $870.96 | Professional | None | $245.47 | $380.19 | $870.96 |
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 $281.84 Median $478.63 Typical High $933.25 | Professional | None | $281.84 | $478.63 | $933.25 |
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 $263.03 Median $389.05 Typical High $724.44 | Professional | None | $263.03 | $389.05 | $724.44 |
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 $102.33 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $102.33 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $47.86 Typical High $58.88 | Professional | 53 · Discontinued | $40.74 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $151.36 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $30.20 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $23.99 Typical High $29.51 | Professional | 56 · Pre-op care only | $20.42 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $169.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $141.25 | $169.82 | $204.17 |
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· 17th of 51
$363
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.