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 $91.20 Median $134.90 Typical High $257.04 | Professional | None | $91.20 | $134.90 | $257.04 |
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 $81.28 Median $151.36 Typical High $288.40 | Professional | None | $81.28 | $151.36 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $186.21 Typical High $234.42 | Facility | None | $100.00 | $186.21 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $407.38 | Professional | None | $104.71 | $194.98 | $407.38 |
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 $123.03 Median $218.78 Typical High $457.09 | Professional | None | $123.03 | $218.78 | $457.09 |
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 $123.03 Median $199.53 Typical High $389.05 | Professional | None | $123.03 | $199.53 | $389.05 |
Well Sense Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
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 $45.71 Median $57.54 Typical High $75.86 | Professional | 52 · Reduced service | $45.71 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $23.44 Typical High $30.20 | Professional | 53 · Discontinued | $18.20 | $23.44 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $87.10 Typical High $114.82 | Professional | 54 · Surgery only | $67.61 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $17.38 Typical High $22.91 | Professional | 55 · Aftercare only | $13.49 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $11.75 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.12 | $11.75 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $81.28 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $63.10 | $81.28 | $107.15 |
Where New Hampshire sits
The same service costs 3.5 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· 13th of 51
$174
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.