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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $134.90 | Professional | None | $91.20 | $123.03 | $134.90 |
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 $100.00 Median $158.49 Typical High $218.78 | Professional | None | $100.00 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $575.44 | Facility | None | $173.78 | $229.09 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $446.68 | Professional | None | $147.91 | $223.87 | $446.68 |
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 $120.23 Median $223.87 Typical High $512.86 | Professional | None | $120.23 | $223.87 | $512.86 |
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 $131.83 Median $204.17 Typical High $398.11 | Professional | None | $131.83 | $204.17 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
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 $45.71 Median $60.26 Typical High $67.61 | Professional | 52 · Reduced service | $45.71 | $60.26 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $24.55 Typical High $26.92 | Professional | 53 · Discontinued | $18.20 | $24.55 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $91.20 Typical High $102.33 | Professional | 54 · Surgery only | $67.61 | $91.20 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.20 Typical High $20.42 | Professional | 55 · Aftercare only | $13.49 | $18.20 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $12.30 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.12 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $85.11 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $63.10 | $85.11 | $95.50 |
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· 16th of 51
$195
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.