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 $204.17 Median $323.59 Typical High $9,772.37 | Facility | None | $204.17 | $323.59 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $602.56 | Professional | None | $204.17 | $323.59 | $602.56 |
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 $199.53 Median $389.05 Typical High $707.95 | Professional | None | $199.53 | $389.05 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $446.68 Typical High $724.44 | Facility | None | $338.84 | $446.68 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $524.81 Typical High $1,047.13 | Professional | None | $269.15 | $524.81 | $1,047.13 |
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 $288.40 Median $537.03 Typical High $1,122.02 | Professional | None | $288.40 | $537.03 | $1,122.02 |
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 $281.84 Median $478.63 Typical High $912.01 | Professional | None | $281.84 | $478.63 | $912.01 |
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 $102.33 Median $141.25 Typical High $194.98 | Professional | 52 · Reduced service | $102.33 | $141.25 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $56.23 Typical High $79.43 | Professional | 53 · Discontinued | $40.74 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $213.80 Typical High $295.12 | Professional | 54 · Surgery only | $151.36 | $213.80 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $42.66 Typical High $58.88 | Professional | 55 · Aftercare only | $30.90 | $42.66 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.18 Typical High $39.81 | Professional | 56 · Pre-op care only | $20.42 | $28.18 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $199.53 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $141.25 | $199.53 | $275.42 |
Where New Hampshire sits
The same service costs 3.5 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· 14th 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.