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 $158.49 Median $245.47 Typical High $251.19 | Professional | None | $158.49 | $245.47 | $251.19 |
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 $128.82 Median $239.88 Typical High $398.11 | Professional | None | $128.82 | $239.88 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $331.13 Typical High $575.44 | Facility | None | $251.19 | $331.13 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $562.34 | Professional | None | $199.53 | $316.23 | $562.34 |
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 $151.36 Median $275.42 Typical High $562.34 | Professional | None | $151.36 | $275.42 | $562.34 |
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 $169.82 Median $295.12 Typical High $512.86 | Professional | None | $169.82 | $295.12 | $512.86 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
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 $79.43 Median $114.82 Typical High $125.89 | Professional | 52 · Reduced service | $79.43 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $45.71 Typical High $50.12 | Professional | 53 · Discontinued | $32.36 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $169.82 Typical High $190.55 | Professional | 54 · Surgery only | $120.23 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $33.88 Typical High $38.02 | Professional | 55 · Aftercare only | $23.99 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.91 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.85 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $158.49 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $112.20 | $158.49 | $177.83 |
Where New Hampshire sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 22nd of 51
$257
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.