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 $436.52 Median $467.74 Typical High $616.60 | Professional | None | $436.52 | $467.74 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $707.95 | Professional | None | $346.74 | $537.03 | $707.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $1,023.29 Typical High $1,445.44 | Professional | 50 · Both sides | $691.83 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,412.54 Typical High $2,089.30 | Facility | None | $812.83 | $1,412.54 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $776.25 Typical High $1,548.82 | Professional | None | $489.78 | $776.25 | $1,548.82 |
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 $407.38 Median $676.08 Typical High $1,288.25 | Professional | None | $407.38 | $676.08 | $1,288.25 |
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 $478.63 Median $707.95 Typical High $1,258.93 | Professional | None | $478.63 | $707.95 | $1,258.93 |
Well Sense Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
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 $218.78 Median $234.42 Typical High $309.03 | Professional | 52 · Reduced service | $218.78 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $123.03 | Professional | 53 · Discontinued | $87.10 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $467.74 | Professional | 54 · Surgery only | $331.13 | $354.81 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $93.33 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $61.66 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $436.52 |
Where New Hampshire sits
The same service costs 4.8 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· 19th of 51
$617
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.