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 $112.20 Median $288.40 Typical High $9,772.37 | Facility | None | $112.20 | $288.40 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $208.93 Typical High $398.11 | Professional | None | $112.20 | $208.93 | $398.11 |
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 $117.49 Median $218.78 Typical High $316.23 | Professional | None | $117.49 | $218.78 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Facility | None | $66.07 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $295.12 Typical High $562.34 | Professional | None | $165.96 | $295.12 | $562.34 |
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 $144.54 Median $275.42 Typical High $630.96 | Professional | None | $144.54 | $275.42 | $630.96 |
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 $154.88 Median $263.03 Typical High $512.86 | Professional | None | $154.88 | $263.03 | $512.86 |
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 $56.23 Median $95.50 Typical High $104.71 | Professional | 52 · Reduced service | $56.23 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $22.39 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $144.54 Typical High $158.49 | Professional | 54 · Surgery only | $85.11 | $144.54 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $28.84 Typical High $31.62 | Professional | 55 · Aftercare only | $16.98 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $19.05 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.22 | $19.05 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $134.90 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $79.43 | $134.90 | $147.91 |
Where New Hampshire sits
The same service costs 4.5 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
$234
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.