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 $537.03 Typical High $575.44 | Professional | None | $489.78 | $537.03 | $575.44 |
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 $478.63 Median $724.44 Typical High $912.01 | Professional | None | $478.63 | $724.44 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,258.93 Typical High $1,862.09 | Professional | 50 · Both sides | $977.24 | $1,258.93 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $269.15 Typical High $575.44 | Facility | None | $204.17 | $269.15 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,584.89 | Professional | None | $676.08 | $794.33 | $1,584.89 |
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 $537.03 Median $776.25 Typical High $1,445.44 | Professional | None | $537.03 | $776.25 | $1,445.44 |
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 $549.54 Median $707.95 Typical High $1,288.25 | Professional | None | $549.54 | $707.95 | $1,288.25 |
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 $245.47 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $245.47 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $114.82 | Professional | 53 · Discontinued | $97.72 | $107.15 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $407.38 Typical High $426.58 | Professional | 54 · Surgery only | $371.54 | $407.38 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $380.19 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $346.74 | $380.19 | $398.11 |
Where New Hampshire sits
The same service costs 5.8 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
$724
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.