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 $309.03 Median $331.13 Typical High $363.08 | Professional | None | $309.03 | $331.13 | $363.08 |
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 $316.23 Median $467.74 Typical High $588.84 | Professional | None | $316.23 | $467.74 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $812.83 Typical High $1,202.26 | Professional | 50 · Both sides | $630.96 | $812.83 | $1,202.26 |
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 $426.58 Median $512.86 Typical High $977.24 | Professional | None | $426.58 | $512.86 | $977.24 |
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 $338.84 Median $501.19 Typical High $977.24 | Professional | None | $338.84 | $501.19 | $977.24 |
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 $338.84 Median $446.68 Typical High $812.83 | Professional | None | $338.84 | $446.68 | $812.83 |
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 $154.88 Median $165.96 Typical High $181.97 | Professional | 52 · Reduced service | $154.88 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $72.44 | Professional | 53 · Discontinued | $61.66 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $251.19 Typical High $275.42 | Professional | 54 · Surgery only | $229.09 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $54.95 | Professional | 55 · Aftercare only | $45.71 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $36.31 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $234.42 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $213.80 | $234.42 | $257.04 |
Where New Hampshire sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$468
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.