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 $165.96 Median $245.47 Typical High $8,912.51 | Facility | None | $165.96 | $245.47 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $467.74 | Professional | None | $165.96 | $245.47 | $467.74 |
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 $151.36 Median $281.84 Typical High $524.81 | Professional | None | $151.36 | $281.84 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $380.19 Typical High $478.63 | Facility | None | $100.00 | $380.19 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $407.38 Typical High $776.25 | Professional | None | $213.80 | $407.38 | $776.25 |
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 $223.87 Median $398.11 Typical High $870.96 | Professional | None | $223.87 | $398.11 | $870.96 |
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 $223.87 Median $363.08 Typical High $676.08 | Professional | None | $223.87 | $363.08 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
7 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 $81.28 Median $100.00 Typical High $147.91 | Professional | 52 · Reduced service | $81.28 | $100.00 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $39.81 Typical High $58.88 | Professional | 53 · Discontinued | $32.36 | $39.81 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $151.36 Typical High $218.78 | Professional | 54 · Surgery only | $120.23 | $151.36 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $30.20 Typical High $43.65 | Professional | 55 · Aftercare only | $23.99 | $30.20 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.95 Typical High $29.51 | Professional | 56 · Pre-op care only | $16.22 | $19.95 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $141.25 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $112.20 | $141.25 | $204.17 |
Ambetter Setting Professional Modifier 51 · Multiple procedures Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | 51 · Multiple procedures | $478.63 | $478.63 | $478.63 |
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· 13th of 51
$324
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.