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 $2,398.83 Median $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $2,089.30 | Professional | None | $724.44 | $870.96 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $1,000.00 Typical High $1,905.46 | Professional | None | $660.69 | $1,000.00 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,137.96 Typical High $2,691.53 | Facility | None | $660.69 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $2,818.38 | Professional | None | $831.76 | $1,258.93 | $2,818.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $933.25 Median $1,548.82 Typical High $3,090.30 | Professional | None | $933.25 | $1,548.82 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $2,454.71 | Professional | None | $891.25 | $1,288.25 | $2,454.71 |
Well Sense Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
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 $354.81 Median $407.38 Typical High $467.74 | Professional | 52 · Reduced service | $354.81 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $186.21 | Professional | 53 · Discontinued | $144.54 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $602.56 Typical High $707.95 | Professional | 54 · Surgery only | $537.03 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $123.03 Typical High $141.25 | Professional | 55 · Aftercare only | $107.15 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $93.33 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $562.34 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $501.19 | $562.34 | $660.69 |
Where New Hampshire sits
The same service costs 4.4 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· 14th of 51
$1,175
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.