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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $316.23 | Professional | None | $251.19 | $269.15 | $316.23 |
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 $169.82 Median $295.12 Typical High $524.81 | Professional | None | $169.82 | $295.12 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,905.46 Typical High $2,398.83 | Facility | None | $575.44 | $1,905.46 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $691.83 | Professional | None | $239.88 | $363.08 | $691.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $741.31 | Professional | None | $223.87 | $371.54 | $741.31 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $660.69 | Professional | None | $234.42 | $331.13 | $660.69 |
Well Sense Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
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 $134.90 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $134.90 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $53.70 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 54 · Surgery only | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $39.81 Typical High $47.86 | Professional | 55 · Aftercare only | $39.81 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $186.21 | $186.21 | $223.87 |
Where New Hampshire sits
The same service costs 5.6 times more in Oklahoma 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· 24th of 51
$316
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.