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 $213.80 Median $302.00 Typical High $660.69 | Professional | None | $213.80 | $302.00 | $660.69 |
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 $204.17 Median $346.74 Typical High $645.65 | Professional | None | $204.17 | $346.74 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $1,862.09 | Facility | None | $575.44 | $1,412.54 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $446.68 Typical High $1,000.00 | Professional | None | $257.04 | $446.68 | $1,000.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $1,071.52 | Professional | None | $295.12 | $524.81 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $288.40 Median $467.74 Typical High $870.96 | Professional | None | $288.40 | $467.74 | $870.96 |
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 $107.15 Median $131.83 Typical High $173.78 | Professional | 52 · Reduced service | $107.15 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $52.48 Typical High $69.18 | Professional | 53 · Discontinued | $42.66 | $52.48 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $194.98 Typical High $257.04 | Professional | 54 · Surgery only | $162.18 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.90 Typical High $52.48 | Professional | 55 · Aftercare only | $32.36 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $26.30 Typical High $34.67 | Professional | 56 · Pre-op care only | $21.38 | $26.30 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $181.97 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $151.36 | $181.97 | $239.88 |
Where New Hampshire sits
The same service costs 4.0 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· 18th of 51
$427
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.