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 $338.84 Median $436.52 Typical High $524.81 | Professional | None | $338.84 | $436.52 | $524.81 |
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 $269.15 Median $416.87 Typical High $575.44 | Professional | None | $269.15 | $416.87 | $575.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $588.84 Median $812.83 Typical High $1,096.48 | Professional | 50 · Both sides | $588.84 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $245.47 Median $338.84 Typical High $457.09 | Professional | 62 · Two surgeons | $245.47 | $338.84 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,162.28 Typical High $3,981.07 | Facility | None | $812.83 | $3,162.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $616.60 Typical High $1,202.26 | Professional | None | $389.05 | $616.60 | $1,202.26 |
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 $316.23 Median $537.03 Typical High $1,023.29 | Professional | None | $316.23 | $537.03 | $1,023.29 |
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 $1,000.00 | Professional | None | $380.19 | $575.44 | $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 $173.78 Median $190.55 Typical High $263.03 | Professional | 52 · Reduced service | $173.78 | $190.55 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $75.86 Typical High $104.71 | Professional | 53 · Discontinued | $70.79 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $281.84 Typical High $389.05 | Professional | 54 · Surgery only | $263.03 | $281.84 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $56.23 Typical High $79.43 | Professional | 55 · Aftercare only | $52.48 | $56.23 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.02 Typical High $52.48 | Professional | 56 · Pre-op care only | $34.67 | $38.02 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $263.03 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $245.47 | $263.03 | $363.08 |
Where New Hampshire sits
The same service costs 5.9 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
$513
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.