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 $165.96 Median $173.78 Typical High $204.17 | Professional | None | $165.96 | $173.78 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $295.12 | Professional | None | $158.49 | $245.47 | $295.12 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $316.23 Median $416.87 Typical High $602.56 | Professional | 50 · Both sides | $316.23 | $416.87 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $257.04 Typical High $323.59 | Facility | None | $100.00 | $257.04 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $281.84 Typical High $512.86 | Professional | None | $213.80 | $281.84 | $512.86 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $501.19 | Professional | None | $173.78 | $257.04 | $501.19 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $446.68 | Professional | None | $181.97 | $245.47 | $446.68 |
Well Sense Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
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 $85.11 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $85.11 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | 53 · Discontinued | $34.67 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $131.83 Typical High $151.36 | Professional | 54 · Surgery only | $128.82 | $131.83 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $26.30 Typical High $30.20 | Professional | 55 · Aftercare only | $26.30 | $26.30 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $123.03 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $123.03 | $123.03 | $141.25 |
Where New Hampshire sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 15th of 51
$245
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.