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 $100.00 Median $134.90 Typical High $8,912.51 | Facility | None | $100.00 | $134.90 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $281.84 | Professional | None | $100.00 | $134.90 | $281.84 |
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 $100.00 Median $186.21 Typical High $331.13 | Professional | None | $100.00 | $186.21 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $575.44 | Facility | None | $169.82 | $223.87 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $269.15 Typical High $467.74 | Professional | None | $144.54 | $269.15 | $467.74 |
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 $128.82 Median $234.42 Typical High $549.54 | Professional | None | $128.82 | $234.42 | $549.54 |
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 $134.90 Median $213.80 Typical High $380.19 | Professional | None | $134.90 | $213.80 | $380.19 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
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 $50.12 Median $63.10 Typical High $67.61 | Professional | 52 · Reduced service | $50.12 | $63.10 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $26.92 | Professional | 53 · Discontinued | $19.95 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $95.50 Typical High $102.33 | Professional | 54 · Surgery only | $74.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $20.42 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.59 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.00 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $89.13 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $69.18 | $89.13 | $95.50 |
Where New Hampshire sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 17th of 51
$204
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.