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 $234.42 Median $331.13 Typical High $331.13 | Professional | None | $234.42 | $331.13 | $331.13 |
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 $190.55 Median $338.84 Typical High $602.56 | Professional | None | $190.55 | $338.84 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $575.44 Typical High $831.76 | Facility | None | $446.68 | $575.44 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $851.14 | Professional | None | $275.42 | $446.68 | $851.14 |
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 $239.88 Median $446.68 Typical High $1,023.29 | Professional | None | $239.88 | $446.68 | $1,023.29 |
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 $281.84 Median $416.87 Typical High $891.25 | Professional | None | $281.84 | $416.87 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
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 $117.49 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $117.49 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $46.77 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $173.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $34.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $23.44 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $162.18 | $229.09 | $229.09 |
Where New Hampshire sits
The same service costs 3.7 times more in Wisconsin 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· 16th of 51
$398
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.