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 $117.49 Median $524.81 Typical High $9,772.37 | Facility | None | $117.49 | $524.81 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $218.78 Typical High $257.04 | Professional | None | $117.49 | $218.78 | $257.04 |
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 $104.71 Median $186.21 Typical High $295.12 | Professional | None | $104.71 | $186.21 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $1,659.59 | Facility | None | $537.03 | $1,258.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $524.81 | Professional | None | $154.88 | $281.84 | $524.81 |
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 $117.49 Median $239.88 Typical High $512.86 | Professional | None | $117.49 | $239.88 | $512.86 |
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 $125.89 Median $234.42 Typical High $457.09 | Professional | None | $125.89 | $234.42 | $457.09 |
Well Sense Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
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 $58.88 Median $107.15 Typical High $109.65 | Professional | 52 · Reduced service | $58.88 | $107.15 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $42.66 Typical High $43.65 | Professional | 53 · Discontinued | $23.44 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $158.49 Typical High $165.96 | Professional | 54 · Surgery only | $89.13 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $32.36 Typical High $33.11 | Professional | 55 · Aftercare only | $17.78 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $21.38 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.75 | $21.38 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $151.36 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $83.18 | $151.36 | $154.88 |
Where New Hampshire sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 21st of 51
$219
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.