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 $630.96 Median $707.95 Typical High $707.95 | Professional | None | $630.96 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,737.80 | Professional | None | $831.76 | $1,230.27 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,862.09 Typical High $2,630.27 | Professional | 50 · Both sides | $1,230.27 | $1,862.09 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,884.03 Typical High $3,981.07 | Facility | None | $575.44 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,949.84 | Professional | None | $812.83 | $954.99 | $1,949.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,905.46 | Professional | None | $660.69 | $977.24 | $1,905.46 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $724.44 Median $891.25 Typical High $1,548.82 | Professional | None | $724.44 | $891.25 | $1,548.82 |
Well Sense Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $316.23 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $128.82 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $478.63 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $63.10 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $489.78 |
Where New Hampshire sits
The same service costs 18.6 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
$1,047
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.