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 $398.11 Median $741.31 Typical High $6,025.60 | Facility | None | $398.11 | $741.31 | $6,025.60 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $416.87 Typical High $741.31 | Professional | None | $251.19 | $416.87 | $741.31 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $724.44 | Professional | None | $407.38 | $436.52 | $724.44 |
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 $218.78 Median $354.81 Typical High $741.31 | Professional | None | $218.78 | $354.81 | $741.31 |
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 $295.12 Median $501.19 Typical High $1,000.00 | Professional | None | $295.12 | $501.19 | $1,000.00 |
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 $275.42 Median $512.86 Typical High $1,148.15 | Professional | None | $275.42 | $512.86 | $1,148.15 |
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 $309.03 Median $501.19 Typical High $1,096.48 | Professional | None | $309.03 | $501.19 | $1,096.48 |
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 $199.53 Median $204.17 Typical High $371.54 | Professional | 52 · Reduced service | $199.53 | $204.17 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $81.28 Typical High $147.91 | Professional | 53 · Discontinued | $79.43 | $81.28 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $549.54 | Professional | 54 · Surgery only | $302.00 | $302.00 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $109.65 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $40.74 Typical High $74.13 | Professional | 56 · Pre-op care only | $39.81 | $40.74 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $281.84 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $281.84 | $281.84 | $512.86 |
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· 30th of 51
$417
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.