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 $154.88 Median $229.09 Typical High $9,772.37 | Facility | None | $154.88 | $229.09 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $436.52 | Professional | None | $154.88 | $229.09 | $436.52 |
Ambetter Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | None | $831.76 | $831.76 | $831.76 |
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 $144.54 Median $257.04 Typical High $478.63 | Professional | None | $144.54 | $257.04 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $323.59 Typical High $575.44 | Facility | None | $251.19 | $323.59 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $338.84 Typical High $707.95 | Professional | None | $186.21 | $338.84 | $707.95 |
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 $208.93 Median $380.19 Typical High $776.25 | Professional | None | $208.93 | $380.19 | $776.25 |
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 $208.93 Median $346.74 Typical High $660.69 | Professional | None | $208.93 | $346.74 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
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 $77.62 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $77.62 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $39.81 Typical High $52.48 | Professional | 53 · Discontinued | $30.90 | $39.81 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $147.91 Typical High $194.98 | Professional | 54 · Surgery only | $117.49 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $29.51 Typical High $38.90 | Professional | 55 · Aftercare only | $23.44 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $19.50 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.49 | $19.50 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $138.04 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $109.65 | $138.04 | $181.97 |
Where New Hampshire sits
The same service costs 3.4 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
$302
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.