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 $177.83 Median $223.87 Typical High $309.03 | Professional | None | $177.83 | $223.87 | $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 $269.15 Typical High $338.84 | Professional | None | $144.54 | $269.15 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $371.54 Typical High $575.44 | Facility | None | $281.84 | $371.54 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $660.69 | Professional | None | $218.78 | $380.19 | $660.69 |
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 $309.03 Typical High $645.65 | Professional | None | $165.96 | $309.03 | $645.65 |
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 $177.83 Median $323.59 Typical High $602.56 | Professional | None | $177.83 | $323.59 | $602.56 |
Well Sense Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Facility | None | $151.36 | $151.36 | $151.36 |
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 $95.50 Median $114.82 Typical High $151.36 | Professional | 52 · Reduced service | $95.50 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $45.71 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $173.78 Typical High $229.09 | Professional | 54 · Surgery only | $141.25 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $34.67 Typical High $45.71 | Professional | 55 · Aftercare only | $28.18 | $34.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $22.91 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.05 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $162.18 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $131.83 | $162.18 | $213.80 |
Where New Hampshire sits
The same service costs 4.4 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· 17th of 51
$288
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.