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 $112.20 Median $120.23 Typical High $131.83 | Professional | None | $112.20 | $120.23 | $131.83 |
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 $104.71 Median $158.49 Typical High $199.53 | Professional | None | $104.71 | $158.49 | $199.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $269.15 Typical High $407.38 | Professional | 50 · Both sides | $208.93 | $269.15 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $158.49 Typical High $199.53 | Facility | None | $100.00 | $158.49 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $331.13 | Professional | None | $144.54 | $181.97 | $331.13 |
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 $117.49 Median $173.78 Typical High $331.13 | Professional | None | $117.49 | $173.78 | $331.13 |
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 $123.03 Median $162.18 Typical High $295.12 | Professional | None | $123.03 | $162.18 | $295.12 |
Well Sense Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
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 $56.23 Median $60.26 Typical High $66.07 | Professional | 52 · Reduced service | $56.23 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $23.99 Typical High $26.30 | Professional | 53 · Discontinued | $22.39 | $23.99 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $89.13 Typical High $100.00 | Professional | 54 · Surgery only | $83.18 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.78 Typical High $19.95 | Professional | 55 · Aftercare only | $16.60 | $17.78 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.02 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.22 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $83.18 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $77.62 | $83.18 | $93.33 |
Where New Hampshire sits
The same service costs 4.5 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· 17th of 51
$162
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.