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 $616.60 Median $724.44 Typical High $11,481.54 | Facility | None | $616.60 | $724.44 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $831.76 | Professional | None | $616.60 | $691.83 | $831.76 |
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 $562.34 Median $870.96 Typical High $1,621.81 | Professional | None | $562.34 | $870.96 | $1,621.81 |
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 $707.95 Median $1,071.52 Typical High $2,398.83 | Professional | None | $707.95 | $1,071.52 | $2,398.83 |
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 $776.25 Median $1,318.26 Typical High $2,630.27 | Professional | None | $776.25 | $1,318.26 | $2,630.27 |
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 $741.31 Median $1,096.48 Typical High $2,089.30 | Professional | None | $741.31 | $1,096.48 | $2,089.30 |
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 $309.03 Median $346.74 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $162.18 | Professional | 53 · Discontinued | $123.03 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $524.81 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $562.34 |
Where New Hampshire sits
The same service costs 4.5 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· 15th of 51
$1,000
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.