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 $234.42 Median $245.47 Typical High $15,848.93 | Facility | None | $234.42 | $245.47 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $245.47 Typical High $933.25 | Professional | None | $234.42 | $245.47 | $933.25 |
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 $331.13 Median $436.52 Typical High $676.08 | Professional | None | $331.13 | $436.52 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,311.31 Typical High $4,168.69 | Facility | None | $933.25 | $3,311.31 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $1,258.93 | Professional | None | $436.52 | $602.56 | $1,258.93 |
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 $426.58 Median $691.83 Typical High $1,348.96 | Professional | None | $426.58 | $691.83 | $1,348.96 |
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 $446.68 Median $562.34 Typical High $1,096.48 | Professional | None | $446.68 | $562.34 | $1,096.48 |
Well Sense Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $117.49 Median $123.03 Typical High $144.54 | Professional | 52 · Reduced service | $117.49 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $48.98 Typical High $57.54 | Professional | 53 · Discontinued | $46.77 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $186.21 Typical High $218.78 | Professional | 54 · Surgery only | $173.78 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $43.65 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $24.55 Typical High $28.84 | Professional | 56 · Pre-op care only | $23.44 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $173.78 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $162.18 | $173.78 | $204.17 |
Where New Hampshire sits
The same service costs 3.8 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· 25th of 51
$525
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.