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 $251.19 Median $707.95 Typical High $9,772.37 | Facility | None | $251.19 | $707.95 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $724.44 | Professional | None | $234.42 | $323.59 | $724.44 |
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 $204.17 Median $380.19 Typical High $724.44 | Professional | None | $204.17 | $380.19 | $724.44 |
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 $295.12 Median $588.84 Typical High $1,047.13 | Professional | None | $295.12 | $588.84 | $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 $316.23 Median $549.54 Typical High $1,096.48 | Professional | None | $316.23 | $549.54 | $1,096.48 |
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 $316.23 Median $524.81 Typical High $1,000.00 | Professional | None | $316.23 | $524.81 | $1,000.00 |
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 $114.82 Median $151.36 Typical High $199.53 | Professional | 52 · Reduced service | $114.82 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $61.66 Typical High $79.43 | Professional | 53 · Discontinued | $45.71 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $229.09 Typical High $295.12 | Professional | 54 · Surgery only | $173.78 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $45.71 Typical High $58.88 | Professional | 55 · Aftercare only | $34.67 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $39.81 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $213.80 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $162.18 | $213.80 | $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· 11th of 51
$457
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.