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 $131.83 Median $186.21 Typical High $9,772.37 | Facility | None | $131.83 | $186.21 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $288.40 | Professional | None | $131.83 | $173.78 | $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 $114.82 Median $208.93 Typical High $389.05 | Professional | None | $114.82 | $208.93 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $208.93 Typical High $263.03 | Facility | None | $100.00 | $208.93 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $269.15 Typical High $575.44 | Professional | None | $147.91 | $269.15 | $575.44 |
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 $173.78 Median $302.00 Typical High $630.96 | Professional | None | $173.78 | $302.00 | $630.96 |
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 $169.82 Median $281.84 Typical High $524.81 | Professional | None | $169.82 | $281.84 | $524.81 |
Well Sense Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
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 $66.07 Median $81.28 Typical High $104.71 | Professional | 52 · Reduced service | $66.07 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $32.36 Typical High $42.66 | Professional | 53 · Discontinued | $26.30 | $32.36 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $120.23 Typical High $158.49 | Professional | 54 · Surgery only | $97.72 | $120.23 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.99 Typical High $31.62 | Professional | 55 · Aftercare only | $19.50 | $23.99 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $16.22 Typical High $20.89 | Professional | 56 · Pre-op care only | $13.18 | $16.22 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $112.20 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $91.20 | $112.20 | $147.91 |
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
$234
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.