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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $309.03 | Professional | None | $173.78 | $239.88 | $309.03 |
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 $281.84 Typical High $346.74 | Professional | None | $144.54 | $281.84 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,412.54 Typical High $1,778.28 | Facility | None | $537.03 | $1,412.54 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $380.19 Typical High $660.69 | Professional | None | $213.80 | $380.19 | $660.69 |
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 $169.82 Median $316.23 Typical High $660.69 | Professional | None | $169.82 | $316.23 | $660.69 |
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 $194.98 Median $323.59 Typical High $616.60 | Professional | None | $194.98 | $323.59 | $616.60 |
Well Sense Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
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 $93.33 Median $120.23 Typical High $151.36 | Professional | 52 · Reduced service | $93.33 | $120.23 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $47.86 Typical High $61.66 | Professional | 53 · Discontinued | $37.15 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $177.83 Typical High $229.09 | Professional | 54 · Surgery only | $138.04 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $35.48 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.99 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.62 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $165.96 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $128.82 | $165.96 | $213.80 |
Where New Hampshire sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$295
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.