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 $5,370.32 Typical High $22,387.21 | Facility | None | $2,398.83 | $5,370.32 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $933.25 | Professional | None | $741.31 | $758.58 | $933.25 |
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 $575.44 Median $912.01 Typical High $1,174.90 | Professional | None | $575.44 | $912.01 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,258.93 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $2,238.72 | Professional | None | $870.96 | $1,202.26 | $2,238.72 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $676.08 Median $1,071.52 Typical High $2,041.74 | Professional | None | $676.08 | $1,071.52 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,862.09 | Professional | None | $794.33 | $1,071.52 | $1,862.09 |
Well Sense Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
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 $371.54 Median $380.19 Typical High $467.74 | Professional | 52 · Reduced service | $371.54 | $380.19 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $186.21 | Professional | 53 · Discontinued | $147.91 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $691.83 | Professional | 54 · Surgery only | $549.54 | $562.34 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $141.25 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $93.33 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $645.65 |
Where New Hampshire sits
The same service costs 5.6 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· 24th of 51
$955
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.