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 $223.87 Median $275.42 Typical High $331.13 | Professional | None | $223.87 | $275.42 | $331.13 |
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 $186.21 Median $288.40 Typical High $380.19 | Professional | None | $186.21 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $933.25 Typical High $1,348.96 | Facility | None | $575.44 | $933.25 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $660.69 | Professional | None | $263.03 | $407.38 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,691.53 | Facility | None | $660.69 | $776.25 | $2,691.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $691.83 | Professional | None | $204.17 | $331.13 | $691.83 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,691.53 | Facility | None | $660.69 | $851.14 | $2,691.53 |
United Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $562.34 | Professional | None | $213.80 | $331.13 | $562.34 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
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 $112.20 Median $138.04 Typical High $165.96 | Professional | 52 · Reduced service | $112.20 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $54.95 Typical High $66.07 | Professional | 53 · Discontinued | $44.67 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $169.82 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $33.88 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $27.54 Typical High $33.11 | Professional | 56 · Pre-op care only | $22.39 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $229.09 |
Where New Hampshire sits
The same service costs 4.3 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· 15th of 51
$324
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.