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 $288.40 Median $338.84 Typical High $9,772.37 | Facility | None | $288.40 | $338.84 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $524.81 | Professional | None | $288.40 | $338.84 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $794.33 | Professional | None | $281.84 | $426.58 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $3,019.95 | Facility | None | $575.44 | $2,187.76 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $1,174.90 | Professional | None | $346.74 | $524.81 | $1,174.90 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $660.69 Typical High $1,318.26 | Professional | None | $389.05 | $660.69 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $1,000.00 | Professional | None | $363.08 | $537.03 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
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 $144.54 Median $169.82 Typical High $199.53 | Professional | 52 · Reduced service | $144.54 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $57.54 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $213.80 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $50.12 Typical High $60.26 | Professional | 55 · Aftercare only | $42.66 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $28.84 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $199.53 | $234.42 | $275.42 |
Where New Hampshire sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 19th of 51
$501
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.