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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $524.81 | Professional | None | $389.05 | $407.38 | $524.81 |
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 $295.12 Median $467.74 Typical High $616.60 | Professional | None | $295.12 | $467.74 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $891.25 Typical High $1,288.25 | Professional | 50 · Both sides | $602.56 | $891.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,691.53 Typical High $3,548.13 | Facility | None | $660.69 | $2,691.53 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $1,258.93 | Professional | None | $436.52 | $676.08 | $1,258.93 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $1,122.02 | Professional | None | $346.74 | $575.44 | $1,122.02 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $1,023.29 | Professional | None | $380.19 | $588.84 | $1,023.29 |
Well Sense Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
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 $194.98 Median $204.17 Typical High $263.03 | Professional | 52 · Reduced service | $194.98 | $204.17 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $81.28 Typical High $104.71 | Professional | 53 · Discontinued | $77.62 | $81.28 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $302.00 Typical High $398.11 | Professional | 54 · Surgery only | $295.12 | $302.00 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $61.66 Typical High $79.43 | Professional | 55 · Aftercare only | $58.88 | $61.66 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $40.74 Typical High $52.48 | Professional | 56 · Pre-op care only | $38.90 | $40.74 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $281.84 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $275.42 | $281.84 | $371.54 |
Where New Hampshire sits
The same service costs 5.0 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· 24th of 51
$525
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.