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 $3,388.44 Typical High $14,791.08 | Facility | None | $2,398.83 | $3,388.44 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $707.95 | Professional | None | $645.65 | $707.95 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $10,000.00 Typical High $18,197.01 | Facility | None | $8,912.51 | $10,000.00 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,288.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,949.84 Typical High $2,754.23 | Professional | 50 · Both sides | $1,258.93 | $1,949.84 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $812.83 Typical High $1,148.15 | Professional | 62 · Two surgeons | $537.03 | $812.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,079.46 Typical High $8,912.51 | Facility | None | $630.96 | $7,079.46 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $2,041.74 | Professional | None | $851.14 | $1,000.00 | $2,041.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $1,995.26 | Professional | None | $691.83 | $1,023.29 | $1,995.26 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,659.59 | Professional | None | $758.58 | $933.25 | $1,659.59 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $134.90 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $512.86 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $102.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $478.63 | $489.78 | $489.78 |
Where New Hampshire sits
The same service costs 8.1 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· 19th 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.