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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $177.83 | Professional | None | $61.66 | $87.10 | $177.83 |
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 $60.26 Median $100.00 Typical High $190.55 | Professional | None | $60.26 | $100.00 | $190.55 |
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 $77.62 Median $134.90 Typical High $302.00 | Professional | None | $77.62 | $134.90 | $302.00 |
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 $87.10 Median $147.91 Typical High $302.00 | Professional | None | $87.10 | $147.91 | $302.00 |
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 $85.11 Median $131.83 Typical High $245.47 | Professional | None | $85.11 | $131.83 | $245.47 |
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 $30.90 Median $38.02 Typical High $51.29 | Professional | 52 · Reduced service | $30.90 | $38.02 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $15.14 Typical High $20.42 | Professional | 53 · Discontinued | $12.30 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $56.23 Typical High $77.62 | Professional | 54 · Surgery only | $46.77 | $56.23 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.22 Typical High $15.49 | Professional | 55 · Aftercare only | $9.33 | $11.22 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.59 Typical High $10.23 | Professional | 56 · Pre-op care only | $6.17 | $7.59 | $10.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $43.65 Median $52.48 Typical High $72.44 | Professional | 78 · Unplanned return to OR | $43.65 | $52.48 | $72.44 |
Where New Hampshire sits
The same service costs 3.8 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· 15th of 51
$120
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.