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 $416.87 Median $416.87 Typical High $489.78 | Professional | None | $416.87 | $416.87 | $489.78 |
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 $398.11 Median $724.44 Typical High $954.99 | Professional | None | $398.11 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $245.47 Typical High $309.03 | Facility | None | $100.00 | $245.47 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $1,096.48 | Professional | None | $478.63 | $588.84 | $1,096.48 |
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 $398.11 Median $575.44 Typical High $1,122.02 | Professional | None | $398.11 | $575.44 | $1,122.02 |
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 $416.87 Median $562.34 Typical High $1,122.02 | Professional | None | $416.87 | $562.34 | $1,122.02 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
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 $208.93 Median $208.93 Typical High $234.42 | Professional | 52 · Reduced service | $208.93 | $208.93 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $316.23 Typical High $346.74 | Professional | 54 · Surgery only | $309.03 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $46.77 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $295.12 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $288.40 | $295.12 | $323.59 |
Where New Hampshire sits
The same service costs 4.2 times more in Wyoming 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· 15th of 51
$631
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.