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 $162.18 Median $208.93 Typical High $288.40 | Professional | None | $162.18 | $208.93 | $288.40 |
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 $138.04 Median $251.19 Typical High $467.74 | Professional | None | $138.04 | $251.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $575.44 | Facility | None | $223.87 | $288.40 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $316.23 Typical High $707.95 | Professional | None | $181.97 | $316.23 | $707.95 |
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 $213.80 Median $363.08 Typical High $741.31 | Professional | None | $213.80 | $363.08 | $741.31 |
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 $208.93 Median $331.13 Typical High $630.96 | Professional | None | $208.93 | $331.13 | $630.96 |
Well Sense Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
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 $81.28 Median $97.72 Typical High $125.89 | Professional | 52 · Reduced service | $81.28 | $97.72 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $38.90 Typical High $50.12 | Professional | 53 · Discontinued | $32.36 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $147.91 Typical High $186.21 | Professional | 54 · Surgery only | $120.23 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $29.51 Typical High $38.02 | Professional | 55 · Aftercare only | $23.99 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.50 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.22 | $19.50 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $138.04 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $112.20 | $138.04 | $173.78 |
Where New Hampshire sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$288
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.