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 $489.78 Median $549.54 Typical High $549.54 | Professional | None | $489.78 | $549.54 | $549.54 |
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 $575.44 Median $1,000.00 Typical High $1,380.38 | Professional | None | $575.44 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,479.11 Typical High $2,041.74 | Professional | 50 · Both sides | $977.24 | $1,479.11 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $2,089.30 | Facility | None | $537.03 | $1,659.59 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $1,548.82 | Professional | None | $630.96 | $758.58 | $1,548.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $1,513.56 | Professional | None | $524.81 | $776.25 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,202.26 | Professional | None | $562.34 | $676.08 | $1,202.26 |
Well Sense Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
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 $245.47 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $338.84 | $380.19 | $380.19 |
Where New Hampshire sits
The same service costs 7.6 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· 17th of 51
$794
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.