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 $407.38 Median $446.68 Typical High $446.68 | Professional | None | $407.38 | $446.68 | $446.68 |
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 $489.78 Median $831.76 Typical High $1,148.15 | Professional | None | $489.78 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,258.93 Typical High $1,698.24 | Professional | 50 · Both sides | $812.83 | $1,258.93 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,884.03 Typical High $3,981.07 | Facility | None | $537.03 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $1,288.25 | Professional | None | $524.81 | $630.96 | $1,288.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,691.53 | Facility | None | $660.69 | $776.25 | $2,691.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,258.93 | Professional | None | $446.68 | $645.65 | $1,258.93 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,691.53 | Facility | None | $660.69 | $851.14 | $2,691.53 |
United Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $1,000.00 | Professional | None | $446.68 | $562.34 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $199.53 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $302.00 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $60.26 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $40.74 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $281.84 | $316.23 | $316.23 |
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· 16th of 51
$661
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.