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 $125.89 Median $144.54 Typical High $338.84 | Professional | None | $125.89 | $144.54 | $338.84 |
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 $120.23 Median $204.17 Typical High $354.81 | Professional | None | $120.23 | $204.17 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $251.19 Typical High $630.96 | Facility | None | $190.55 | $251.19 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $575.44 | Professional | None | $173.78 | $302.00 | $575.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $147.91 Median $257.04 Typical High $588.84 | Professional | None | $147.91 | $257.04 | $588.84 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $398.11 | Professional | None | $158.49 | $223.87 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
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 $63.10 Median $67.61 Typical High $72.44 | Professional | 52 · Reduced service | $63.10 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $27.54 Typical High $28.84 | Professional | 53 · Discontinued | $25.12 | $27.54 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $107.15 | Professional | 54 · Surgery only | $93.33 | $102.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $21.38 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.80 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.59 | $13.80 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $95.50 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $87.10 | $95.50 | $100.00 |
Where New Hampshire sits
The same service costs 3.9 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· 16th of 51
$229
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.