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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $281.84 Typical High $549.54 | Professional | None | $190.55 | $281.84 | $549.54 |
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 $181.97 Median $316.23 Typical High $588.84 | Professional | None | $181.97 | $316.23 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $1,096.48 | Facility | None | $549.54 | $741.31 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $891.25 | Professional | None | $229.09 | $416.87 | $891.25 |
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 $257.04 Median $478.63 Typical High $977.24 | Professional | None | $257.04 | $478.63 | $977.24 |
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 $251.19 Median $426.58 Typical High $812.83 | Professional | None | $251.19 | $426.58 | $812.83 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
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 $95.50 Median $120.23 Typical High $158.49 | Professional | 52 · Reduced service | $95.50 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $47.86 Typical High $63.10 | Professional | 53 · Discontinued | $38.02 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $181.97 Typical High $239.88 | Professional | 54 · Surgery only | $144.54 | $181.97 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $47.86 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.05 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $169.82 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $134.90 | $169.82 | $223.87 |
Where New Hampshire sits
The same service costs 3.6 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· 16th of 51
$380
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.