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 $257.04 Median $288.40 Typical High $309.03 | Professional | None | $257.04 | $288.40 | $309.03 |
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 $275.42 Median $398.11 Typical High $501.19 | Professional | None | $275.42 | $398.11 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $691.83 Typical High $1,047.13 | Professional | 50 · Both sides | $549.54 | $691.83 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $575.44 | Facility | None | $204.17 | $269.15 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $851.14 | Professional | None | $363.08 | $426.58 | $851.14 |
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 $295.12 Median $426.58 Typical High $812.83 | Professional | None | $295.12 | $426.58 | $812.83 |
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 $288.40 Median $371.54 Typical High $676.08 | Professional | None | $288.40 | $371.54 | $676.08 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
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 $131.83 Median $144.54 Typical High $151.36 | Professional | 52 · Reduced service | $131.83 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $52.48 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $213.80 Typical High $229.09 | Professional | 54 · Surgery only | $194.98 | $213.80 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $42.66 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $199.53 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $181.97 | $199.53 | $213.80 |
Where New Hampshire sits
The same service costs 5.9 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· 14th of 51
$398
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.