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 $389.05 Median $1,819.70 Typical High $9,772.37 | Facility | None | $389.05 | $1,819.70 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $562.34 | Professional | None | $363.08 | $389.05 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $616.60 | Professional | None | $251.19 | $407.38 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,818.38 Typical High $3,890.45 | Facility | None | $537.03 | $2,818.38 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $660.69 | Professional | None | $281.84 | $398.11 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $223.87 Median $331.13 Typical High $660.69 | Professional | None | $223.87 | $331.13 | $660.69 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $794.33 | Professional | None | $234.42 | $338.84 | $794.33 |
Well Sense Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
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 $181.97 Median $194.98 Typical High $194.98 | Professional | 52 · Reduced service | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $275.42 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $275.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $257.04 | $275.42 | $275.42 |
Where New Hampshire sits
The same service costs 4.6 times more in Alaska 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· 22nd of 51
$389
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.