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 $316.23 Median $389.05 Typical High $501.19 | Professional | None | $316.23 | $389.05 | $501.19 |
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 $275.42 Median $436.52 Typical High $588.84 | Professional | None | $275.42 | $436.52 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $831.76 Typical High $1,122.02 | Professional | 50 · Both sides | $549.54 | $831.76 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $724.44 | Facility | None | $416.87 | $537.03 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $645.65 Typical High $1,230.27 | Professional | None | $398.11 | $645.65 | $1,230.27 |
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 $323.59 Median $549.54 Typical High $1,071.52 | Professional | None | $323.59 | $549.54 | $1,071.52 |
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 $380.19 Median $575.44 Typical High $1,047.13 | Professional | None | $380.19 | $575.44 | $1,047.13 |
Well Sense Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
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 $169.82 Median $194.98 Typical High $251.19 | Professional | 52 · Reduced service | $169.82 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $77.62 Typical High $100.00 | Professional | 53 · Discontinued | $67.61 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $295.12 Typical High $371.54 | Professional | 54 · Surgery only | $251.19 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $58.88 Typical High $74.13 | Professional | 55 · Aftercare only | $50.12 | $58.88 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.90 Typical High $50.12 | Professional | 56 · Pre-op care only | $33.88 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $275.42 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $234.42 | $275.42 | $346.74 |
Where New Hampshire sits
The same service costs 4.7 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· 18th of 51
$501
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.