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 $83.18 Median $109.65 Typical High $165.96 | Professional | None | $83.18 | $109.65 | $165.96 |
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 $75.86 Median $138.04 Typical High $263.03 | Professional | None | $75.86 | $138.04 | $263.03 |
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 $95.50 Median $186.21 Typical High $371.54 | Professional | None | $95.50 | $186.21 | $371.54 |
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 $114.82 Median $199.53 Typical High $436.52 | Professional | None | $114.82 | $199.53 | $436.52 |
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 $112.20 Median $186.21 Typical High $354.81 | Professional | None | $112.20 | $186.21 | $354.81 |
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 $41.69 Median $54.95 Typical High $72.44 | Professional | 52 · Reduced service | $41.69 | $54.95 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $21.88 Typical High $28.84 | Professional | 53 · Discontinued | $16.60 | $21.88 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $81.28 Typical High $107.15 | Professional | 54 · Surgery only | $61.66 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $16.22 Typical High $21.38 | Professional | 55 · Aftercare only | $12.30 | $16.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.96 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.32 | $10.96 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $57.54 Median $75.86 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $57.54 | $75.86 | $100.00 |
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· 14th of 51
$162
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.