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 $616.60 Median $707.95 Typical High $707.95 | Professional | None | $616.60 | $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 $1,412.54 Typical High $1,949.84 | Professional | None | $831.76 | $1,412.54 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $2,089.30 Typical High $2,951.21 | Professional | 50 · Both sides | $1,380.38 | $2,089.30 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $891.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $575.44 | $891.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,981.07 Typical High $5,011.87 | Facility | None | $630.96 | $3,981.07 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $2,187.76 | Professional | None | $912.01 | $1,071.52 | $2,187.76 |
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 $741.31 Median $1,047.13 Typical High $1,905.46 | Professional | None | $741.31 | $1,047.13 | $1,905.46 |
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 $831.76 Median $1,000.00 Typical High $1,819.70 | Professional | None | $831.76 | $1,000.00 | $1,819.70 |
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 $309.03 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $123.03 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $457.09 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $61.66 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $489.78 |
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
$1,148
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.