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 $245.47 Median $269.15 Typical High $295.12 | Professional | None | $245.47 | $269.15 | $295.12 |
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 $229.09 Median $354.81 Typical High $436.52 | Professional | None | $229.09 | $354.81 | $436.52 |
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 $323.59 Median $398.11 Typical High $741.31 | Professional | None | $323.59 | $398.11 | $741.31 |
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 $263.03 Median $371.54 Typical High $724.44 | Professional | None | $263.03 | $371.54 | $724.44 |
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 $295.12 Median $354.81 Typical High $645.65 | Professional | None | $295.12 | $354.81 | $645.65 |
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 $120.23 Median $134.90 Typical High $147.91 | Professional | 52 · Reduced service | $120.23 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $53.70 Typical High $60.26 | Professional | 53 · Discontinued | $48.98 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $199.53 Typical High $223.87 | Professional | 54 · Surgery only | $181.97 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $40.74 Typical High $44.67 | Professional | 55 · Aftercare only | $36.31 | $40.74 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $26.92 Typical High $29.51 | Professional | 56 · Pre-op care only | $24.55 | $26.92 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $186.21 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $169.82 | $186.21 | $208.93 |
Where New Hampshire sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$355
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.