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 $436.52 Median $489.78 Typical High $602.56 | Professional | None | $436.52 | $489.78 | $602.56 |
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 $338.84 Median $537.03 Typical High $691.83 | Professional | None | $338.84 | $537.03 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,570.40 Typical High $3,548.13 | Facility | None | $575.44 | $2,570.40 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $691.83 Typical High $1,412.54 | Professional | None | $489.78 | $691.83 | $1,412.54 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,258.93 | Professional | None | $398.11 | $645.65 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,174.90 | Professional | None | $467.74 | $676.08 | $1,174.90 |
Well Sense Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
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 $229.09 Median $245.47 Typical High $302.00 | Professional | 52 · Reduced service | $229.09 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $120.23 | Professional | 53 · Discontinued | $91.20 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $371.54 Typical High $457.09 | Professional | 54 · Surgery only | $346.74 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $91.20 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $60.26 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $346.74 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $323.59 | $346.74 | $426.58 |
Where New Hampshire sits
The same service costs 6.0 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· 20th of 51
$603
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.