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 $331.13 Median $407.38 Typical High $489.78 | Professional | None | $331.13 | $407.38 | $489.78 |
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 $323.59 Median $537.03 Typical High $954.99 | Professional | None | $323.59 | $537.03 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $100.00 Typical High $151.36 | Facility | None | $66.07 | $100.00 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,445.44 | Professional | None | $398.11 | $645.65 | $1,445.44 |
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 $446.68 Median $776.25 Typical High $1,445.44 | Professional | None | $446.68 | $776.25 | $1,445.44 |
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 $436.52 Median $660.69 Typical High $1,288.25 | Professional | None | $436.52 | $660.69 | $1,288.25 |
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 $165.96 Median $204.17 Typical High $239.88 | Professional | 52 · Reduced service | $165.96 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $81.28 Typical High $97.72 | Professional | 53 · Discontinued | $66.07 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $251.19 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $60.26 Typical High $72.44 | Professional | 55 · Aftercare only | $50.12 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $40.74 Typical High $48.98 | Professional | 56 · Pre-op care only | $33.11 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $234.42 | $281.84 | $338.84 |
Where New Hampshire sits
The same service costs 4.7 times more in Alaska than in Texas. 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· 13th of 51
$575
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.