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 $85.11 Median $95.50 Typical High $120.23 | Professional | None | $85.11 | $95.50 | $120.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $162.18 | Professional | None | $74.13 | $125.89 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $147.91 Median $229.09 Typical High $309.03 | Professional | 50 · Both sides | $147.91 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $177.83 Typical High $724.44 | Facility | None | $134.90 | $177.83 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $309.03 | Professional | None | $117.49 | $177.83 | $309.03 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $87.10 Median $147.91 Typical High $295.12 | Professional | None | $87.10 | $147.91 | $295.12 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $251.19 | Professional | None | $100.00 | $147.91 | $251.19 |
Well Sense Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
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 $44.67 Median $46.77 Typical High $58.88 | Professional | 52 · Reduced service | $44.67 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.62 Typical High $23.99 | Professional | 53 · Discontinued | $17.78 | $18.62 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $70.79 Typical High $89.13 | Professional | 54 · Surgery only | $67.61 | $70.79 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.13 Typical High $17.78 | Professional | 55 · Aftercare only | $13.49 | $14.13 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $66.07 Typical High $83.18 | Professional | 78 · Unplanned return to OR | $63.10 | $66.07 | $83.18 |
Where New Hampshire sits
The same service costs 3.7 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
$138
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.