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 $51.29 Median $89.13 Typical High $8,912.51 | Facility | None | $51.29 | $89.13 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $144.54 | Professional | None | $51.29 | $74.13 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $77.62 Median $138.04 Typical High $223.87 | Professional | None | $77.62 | $138.04 | $223.87 |
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 $48.98 Median $69.18 Typical High $112.20 | Professional | None | $48.98 | $69.18 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Facility | None | $66.07 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $208.93 | Professional | None | $60.26 | $97.72 | $208.93 |
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 $66.07 Median $109.65 Typical High $218.78 | Professional | None | $66.07 | $109.65 | $218.78 |
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 $61.66 Median $91.20 Typical High $173.78 | Professional | None | $61.66 | $91.20 | $173.78 |
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 $25.70 Median $28.84 Typical High $37.15 | Professional | 52 · Reduced service | $25.70 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $11.48 Typical High $14.79 | Professional | 53 · Discontinued | $10.23 | $11.48 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $42.66 Typical High $54.95 | Professional | 54 · Surgery only | $38.02 | $42.66 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.51 Typical High $10.96 | Professional | 55 · Aftercare only | $7.59 | $8.51 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.75 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.13 | $5.75 | $7.41 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $35.48 Median $39.81 Typical High $51.29 | Professional | 78 · Unplanned return to OR | $35.48 | $39.81 | $51.29 |
Where New Hampshire sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 18th of 51
$81.28
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.