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 $141.25 Median $239.88 Typical High $251.19 | Professional | None | $141.25 | $239.88 | $251.19 |
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 $131.83 Median $239.88 Typical High $380.19 | Professional | None | $131.83 | $239.88 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $398.11 Typical High $575.44 | Facility | None | $302.00 | $398.11 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $575.44 | Professional | None | $213.80 | $354.81 | $575.44 |
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 $151.36 Median $295.12 Typical High $645.65 | Professional | None | $151.36 | $295.12 | $645.65 |
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 $154.88 Median $275.42 Typical High $512.86 | Professional | None | $154.88 | $275.42 | $512.86 |
Well Sense Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
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 $70.79 Median $117.49 Typical High $125.89 | Professional | 52 · Reduced service | $70.79 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $46.77 Typical High $50.12 | Professional | 53 · Discontinued | $28.18 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $173.78 Typical High $190.55 | Professional | 54 · Surgery only | $104.71 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $34.67 Typical High $38.02 | Professional | 55 · Aftercare only | $20.89 | $34.67 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $23.44 Typical High $25.12 | Professional | 56 · Pre-op care only | $14.13 | $23.44 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $162.18 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $97.72 | $162.18 | $177.83 |
Where New Hampshire sits
The same service costs 3.5 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· 19th of 51
$269
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.