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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $398.11 | Professional | None | $263.03 | $309.03 | $398.11 |
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 $223.87 Median $389.05 Typical High $724.44 | Professional | None | $223.87 | $389.05 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $363.08 Typical High $457.09 | Facility | None | $100.00 | $363.08 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $467.74 Typical High $1,071.52 | Professional | None | $295.12 | $467.74 | $1,071.52 |
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 $346.74 Median $562.34 Typical High $1,122.02 | Professional | None | $346.74 | $562.34 | $1,122.02 |
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 $323.59 Median $489.78 Typical High $933.25 | Professional | None | $323.59 | $489.78 | $933.25 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
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 $128.82 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $128.82 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $61.66 Typical High $72.44 | Professional | 53 · Discontinued | $52.48 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $194.98 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $38.90 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.30 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $181.97 | $213.80 | $257.04 |
Where New Hampshire sits
The same service costs 4.0 times more in Alaska than in Texas. 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
$447
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.