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 $151.36 Median $190.55 Typical High $8,912.51 | Facility | None | $151.36 | $190.55 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $190.55 Typical High $346.74 | Professional | None | $131.83 | $190.55 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $316.23 Typical High $524.81 | Professional | None | $109.65 | $316.23 | $524.81 |
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 $95.50 Median $169.82 Typical High $302.00 | Professional | None | $95.50 | $169.82 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $204.17 Typical High $575.44 | Facility | None | $154.88 | $204.17 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $251.19 Typical High $457.09 | Professional | None | $134.90 | $251.19 | $457.09 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $138.04 Median $245.47 Typical High $489.78 | Professional | None | $138.04 | $245.47 | $489.78 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $138.04 Median $213.80 Typical High $398.11 | Professional | None | $138.04 | $213.80 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
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 $57.54 Median $81.28 Typical High $95.50 | Professional | 52 · Reduced service | $57.54 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $22.91 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $87.10 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $23.99 Typical High $28.18 | Professional | 55 · Aftercare only | $17.38 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $11.48 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $112.20 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $81.28 | $112.20 | $131.83 |
Where New Hampshire sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$200
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.