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 $186.21 Median $208.93 Typical High $9,772.37 | Facility | None | $186.21 | $208.93 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $186.21 Typical High $346.74 | Professional | None | $141.25 | $186.21 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $436.52 | Professional | None | $147.91 | $190.55 | $436.52 |
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 $107.15 Median $173.78 Typical High $229.09 | Professional | None | $107.15 | $173.78 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $151.36 Typical High $630.96 | Facility | None | $107.15 | $151.36 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $239.88 Typical High $407.38 | Professional | None | $169.82 | $239.88 | $407.38 |
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 $204.17 Typical High $389.05 | Professional | None | $128.82 | $204.17 | $389.05 |
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 $154.88 Median $204.17 Typical High $354.81 | Professional | None | $154.88 | $204.17 | $354.81 |
Well Sense Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
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 $74.13 Median $93.33 Typical High $104.71 | Professional | 52 · Reduced service | $74.13 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $38.02 Typical High $41.69 | Professional | 53 · Discontinued | $29.51 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $141.25 Typical High $158.49 | Professional | 54 · Surgery only | $109.65 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $22.39 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $14.79 | $18.62 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $131.83 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $102.33 | $131.83 | $147.91 |
Where New Hampshire sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$195
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.