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 $724.44 Median $812.83 Typical High $812.83 | Professional | None | $724.44 | $812.83 | $812.83 |
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 $933.25 Median $1,445.44 Typical High $1,995.26 | Professional | None | $933.25 | $1,445.44 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $2,137.96 Typical High $3,019.95 | Professional | 50 · Both sides | $1,412.54 | $2,137.96 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,884.03 Typical High $3,981.07 | Facility | None | $660.69 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $2,238.72 | Professional | None | $912.01 | $1,096.48 | $2,238.72 |
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 $758.58 Median $1,122.02 Typical High $2,187.76 | Professional | None | $758.58 | $1,122.02 | $2,187.76 |
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 $794.33 Median $1,000.00 Typical High $1,862.09 | Professional | None | $794.33 | $1,000.00 | $1,862.09 |
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 $363.08 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $144.54 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $575.44 |
Where New Hampshire sits
The same service costs 7.8 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· 18th of 51
$1,175
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.