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 $275.42 Median $309.03 Typical High $9,772.37 | Facility | None | $275.42 | $309.03 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $281.84 Typical High $323.59 | Professional | None | $263.03 | $281.84 | $323.59 |
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 $281.84 Median $426.58 Typical High $512.86 | Professional | None | $281.84 | $426.58 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $724.44 Typical High $1,071.52 | Professional | 50 · Both sides | $549.54 | $724.44 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $257.04 Typical High $323.59 | Facility | None | $100.00 | $257.04 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $851.14 | Professional | None | $371.54 | $457.09 | $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 $302.00 Median $446.68 Typical High $851.14 | Professional | None | $302.00 | $446.68 | $851.14 |
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 $269.15 Median $389.05 Typical High $691.83 | Professional | None | $269.15 | $389.05 | $691.83 |
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 $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $131.83 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $52.48 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $199.53 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $41.69 Typical High $45.71 | Professional | 55 · Aftercare only | $39.81 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.30 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $186.21 | $190.55 | $213.80 |
Where New Hampshire sits
The same service costs 5.4 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
$417
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.