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 $165.96 Median $512.86 Typical High $9,772.37 | Facility | None | $165.96 | $512.86 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $229.09 | Professional | None | $165.96 | $194.98 | $229.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $380.19 | Professional | None | $144.54 | $234.42 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $323.59 Typical High $575.44 | Facility | None | $245.47 | $323.59 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $602.56 | Professional | None | $204.17 | $323.59 | $602.56 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,691.53 | Facility | None | $660.69 | $776.25 | $2,691.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $281.84 Typical High $549.54 | Professional | None | $165.96 | $281.84 | $549.54 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,691.53 | Facility | None | $660.69 | $851.14 | $2,691.53 |
United Setting Professional Modifier None Typical Low $190.55 Median $288.40 Typical High $501.19 | Professional | None | $190.55 | $288.40 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Facility | None | $117.49 | $117.49 | $117.49 |
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 $83.18 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $83.18 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $33.11 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $169.82 | Professional | 54 · Surgery only | $125.89 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $33.88 | Professional | 55 · Aftercare only | $25.12 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.60 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $134.90 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $117.49 | $134.90 | $158.49 |
Where New Hampshire sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 18th of 51
$269
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.