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 $3,890.45 Typical High $15,848.93 | Facility | None | $2,398.83 | $3,890.45 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $776.25 | Professional | None | $676.08 | $776.25 | $776.25 |
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 $870.96 Median $1,288.25 Typical High $1,819.70 | Professional | None | $870.96 | $1,288.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,905.46 Typical High $2,754.23 | Professional | 50 · Both sides | $1,258.93 | $1,905.46 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,162.28 Typical High $3,981.07 | Facility | None | $630.96 | $3,162.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $2,041.74 | Professional | None | $812.83 | $1,000.00 | $2,041.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,737.80 | Professional | None | $676.08 | $977.24 | $1,737.80 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,659.59 | Professional | None | $741.31 | $933.25 | $1,659.59 |
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 $338.84 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $134.90 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $67.61 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $537.03 |
Where New Hampshire sits
The same service costs 16.6 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· 15th of 51
$1,072
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.