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 $199.53 Median $281.84 Typical High $8,912.51 | Facility | None | $199.53 | $281.84 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $549.54 | Professional | None | $199.53 | $281.84 | $549.54 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $524.81 Typical High $524.81 | Professional | None | $181.97 | $524.81 | $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 $173.78 Median $316.23 Typical High $588.84 | Professional | None | $173.78 | $316.23 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $398.11 Typical High $501.19 | Facility | None | $100.00 | $398.11 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $467.74 Typical High $870.96 | Professional | None | $245.47 | $467.74 | $870.96 |
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 $251.19 Median $457.09 Typical High $977.24 | Professional | None | $251.19 | $457.09 | $977.24 |
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 $245.47 Median $416.87 Typical High $758.58 | Professional | None | $245.47 | $416.87 | $758.58 |
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 |
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 $162.18 | Professional | 52 · Reduced service | $95.50 | $120.23 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $47.86 Typical High $64.57 | Professional | 53 · Discontinued | $38.02 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $181.97 Typical High $245.47 | Professional | 54 · Surgery only | $141.25 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $48.98 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $32.36 | Professional | 56 · Pre-op care only | $19.05 | $23.99 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $169.82 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $134.90 | $169.82 | $229.09 |
Where New Hampshire sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 12th of 51
$372
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.