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 $186.21 Median $281.84 Typical High $309.03 | Professional | None | $186.21 | $281.84 | $309.03 |
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 $154.88 Median $275.42 Typical High $489.78 | Professional | None | $154.88 | $275.42 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $407.38 Typical High $575.44 | Facility | None | $309.03 | $407.38 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $707.95 | Professional | None | $223.87 | $371.54 | $707.95 |
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 $190.55 Median $363.08 Typical High $831.76 | Professional | None | $190.55 | $363.08 | $831.76 |
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 $229.09 Median $363.08 Typical High $758.58 | Professional | None | $229.09 | $363.08 | $758.58 |
Well Sense Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
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 $93.33 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $93.33 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $37.15 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $27.54 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $18.62 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $199.53 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $199.53 | $199.53 |
Where New Hampshire sits
The same service costs 4.3 times more in Wisconsin 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· 18th of 51
$324
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.