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 $257.04 Median $323.59 Typical High $9,772.37 | Facility | None | $257.04 | $323.59 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $602.56 | Professional | None | $281.84 | $323.59 | $602.56 |
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 $309.03 Median $436.52 Typical High $549.54 | Professional | None | $309.03 | $436.52 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $257.04 Typical High $323.59 | Facility | None | $100.00 | $257.04 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $933.25 | Professional | None | $398.11 | $478.63 | $933.25 |
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 $331.13 Median $467.74 Typical High $891.25 | Professional | None | $331.13 | $467.74 | $891.25 |
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 $269.15 Median $407.38 Typical High $741.31 | Professional | None | $269.15 | $407.38 | $741.31 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
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 $141.25 Median $151.36 Typical High $162.18 | Professional | 52 · Reduced service | $141.25 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $60.26 Typical High $64.57 | Professional | 53 · Discontinued | $56.23 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $245.47 | Professional | 54 · Surgery only | $208.93 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $45.71 Typical High $48.98 | Professional | 55 · Aftercare only | $41.69 | $45.71 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $32.36 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $229.09 |
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· 14th of 51
$437
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.