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 $131.83 Median $131.83 Typical High $144.54 | Professional | None | $131.83 | $131.83 | $144.54 |
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 $147.91 Median $239.88 Typical High $380.19 | Professional | None | $147.91 | $239.88 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $1,659.59 | Facility | None | $537.03 | $1,258.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $575.44 | Professional | None | $223.87 | $354.81 | $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 $177.83 Median $302.00 Typical High $562.34 | Professional | None | $177.83 | $302.00 | $562.34 |
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 $181.97 Median $251.19 Typical High $416.87 | Professional | None | $181.97 | $251.19 | $416.87 |
Well Sense Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
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 $66.07 Median $66.07 Typical High $72.44 | Professional | 52 · Reduced service | $66.07 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $28.84 | Professional | 53 · Discontinued | $26.30 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $109.65 | Professional | 54 · Surgery only | $97.72 | $97.72 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $21.88 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $14.45 | Professional | 56 · Pre-op care only | $13.18 | $13.18 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $91.20 | $91.20 | $102.33 |
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· 22nd of 51
$251
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.