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 $95.50 Median $154.88 Typical High $177.83 | Professional | None | $95.50 | $154.88 | $177.83 |
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 $102.33 Median $194.98 Typical High $281.84 | Professional | None | $102.33 | $194.98 | $281.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $316.23 Typical High $562.34 | Professional | 50 · Both sides | $190.55 | $316.23 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $245.47 Typical High $309.03 | Facility | None | $100.00 | $245.47 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $263.03 Typical High $489.78 | Professional | None | $158.49 | $263.03 | $489.78 |
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 $125.89 Median $251.19 Typical High $602.56 | Professional | None | $125.89 | $251.19 | $602.56 |
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 $141.25 Median $245.47 Typical High $489.78 | Professional | None | $141.25 | $245.47 | $489.78 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
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 $47.86 Median $74.13 Typical High $83.18 | Professional | 52 · Reduced service | $47.86 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $30.20 Typical High $33.11 | Professional | 53 · Discontinued | $19.05 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $112.20 Typical High $123.03 | Professional | 54 · Surgery only | $70.79 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $22.39 Typical High $24.55 | Professional | 55 · Aftercare only | $14.13 | $22.39 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.14 Typical High $16.60 | Professional | 56 · Pre-op care only | $9.55 | $15.14 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $104.71 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $66.07 | $104.71 | $114.82 |
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· 19th of 51
$209
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.