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 $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $446.68 | Professional | None | $288.40 | $331.13 | $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 $223.87 Median $363.08 Typical High $489.78 | Professional | None | $223.87 | $363.08 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $691.83 Typical High $933.25 | Professional | 50 · Both sides | $489.78 | $691.83 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,884.03 Typical High $3,981.07 | Facility | None | $575.44 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $1,000.00 | Professional | None | $331.13 | $537.03 | $1,000.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $891.25 | Professional | None | $263.03 | $467.74 | $891.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $891.25 | Professional | None | $323.59 | $501.19 | $891.25 |
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 $144.54 Median $165.96 Typical High $223.87 | Professional | 52 · Reduced service | $144.54 | $165.96 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $66.07 Typical High $89.13 | Professional | 53 · Discontinued | $57.54 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $245.47 Typical High $331.13 | Professional | 54 · Surgery only | $218.78 | $245.47 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $48.98 Typical High $67.61 | Professional | 55 · Aftercare only | $43.65 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.11 Typical High $44.67 | Professional | 56 · Pre-op care only | $28.84 | $33.11 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $229.09 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $204.17 | $229.09 | $309.03 |
Where New Hampshire sits
The same service costs 5.5 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· 18th of 51
$437
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.