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 $109.65 Median $165.96 Typical High $269.15 | Professional | None | $109.65 | $165.96 | $269.15 |
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 $181.97 Typical High $288.40 | Professional | None | $100.00 | $181.97 | $288.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $302.00 Typical High $562.34 | Professional | 50 · Both sides | $194.98 | $302.00 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,187.76 Typical High $3,019.95 | Facility | None | $537.03 | $2,187.76 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $257.04 Typical High $436.52 | Professional | None | $141.25 | $257.04 | $436.52 |
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 $144.54 Median $251.19 Typical High $562.34 | Professional | None | $144.54 | $251.19 | $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 $138.04 Median $234.42 Typical High $501.19 | Professional | None | $138.04 | $234.42 | $501.19 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
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 $54.95 Median $83.18 Typical High $134.90 | Professional | 52 · Reduced service | $54.95 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $33.11 Typical High $53.70 | Professional | 53 · Discontinued | $22.39 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $125.89 Typical High $199.53 | Professional | 54 · Surgery only | $83.18 | $125.89 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.12 Typical High $39.81 | Professional | 55 · Aftercare only | $16.60 | $25.12 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $16.60 Typical High $26.92 | Professional | 56 · Pre-op care only | $10.96 | $16.60 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $117.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $77.62 | $117.49 | $186.21 |
Where New Hampshire sits
The same service costs 4.8 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· 19th of 51
$209
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.