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 $239.88 Median $338.84 Typical High $338.84 | Professional | None | $239.88 | $338.84 | $338.84 |
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 $186.21 Median $346.74 Typical High $630.96 | Professional | None | $186.21 | $346.74 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $380.19 Typical High $724.44 | Facility | None | $288.40 | $380.19 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $831.76 | Professional | None | $263.03 | $426.58 | $831.76 |
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 $436.52 Typical High $977.24 | Professional | None | $239.88 | $436.52 | $977.24 |
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 $407.38 Typical High $912.01 | Professional | None | $281.84 | $407.38 | $912.01 |
Well Sense Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
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 $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $47.86 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $177.83 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $35.48 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $165.96 | $239.88 | $239.88 |
Where New Hampshire sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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
$389
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.