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 $117.49 Median $134.90 Typical High $190.55 | Professional | None | $117.49 | $134.90 | $190.55 |
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 $100.00 Median $173.78 Typical High $302.00 | Professional | None | $100.00 | $173.78 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $181.97 Typical High $630.96 | Facility | None | $138.04 | $181.97 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $478.63 | Professional | None | $144.54 | $263.03 | $478.63 |
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 $131.83 Median $223.87 Typical High $524.81 | Professional | None | $131.83 | $223.87 | $524.81 |
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 $154.88 Median $208.93 Typical High $363.08 | Professional | None | $154.88 | $208.93 | $363.08 |
Well Sense Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
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 $26.92 Typical High $28.84 | Professional | 53 · Discontinued | $25.12 | $26.92 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $107.15 | Professional | 54 · Surgery only | $93.33 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $13.49 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.59 | $13.49 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $93.33 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $87.10 | $93.33 | $100.00 |
Where New Hampshire sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 20th of 51
$200
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.