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 $371.54 Median $467.74 Typical High $616.60 | Professional | None | $371.54 | $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 $363.08 Median $660.69 Typical High $812.83 | Professional | None | $363.08 | $660.69 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $724.44 Median $1,122.02 Typical High $1,479.11 | Professional | 50 · Both sides | $724.44 | $1,122.02 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $2,818.38 | Facility | None | $575.44 | $2,187.76 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $870.96 Typical High $1,548.82 | Professional | None | $501.19 | $870.96 | $1,548.82 |
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 $407.38 Median $758.58 Typical High $1,513.56 | Professional | None | $407.38 | $758.58 | $1,513.56 |
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 $416.87 Median $707.95 Typical High $1,380.38 | Professional | None | $416.87 | $707.95 | $1,380.38 |
Well Sense Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
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 $186.21 Median $234.42 Typical High $309.03 | Professional | 52 · Reduced service | $186.21 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $95.50 Typical High $123.03 | Professional | 53 · Discontinued | $74.13 | $95.50 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $354.81 Typical High $457.09 | Professional | 54 · Surgery only | $281.84 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $70.79 Typical High $91.20 | Professional | 55 · Aftercare only | $56.23 | $70.79 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $46.77 Typical High $61.66 | Professional | 56 · Pre-op care only | $37.15 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $331.13 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $263.03 | $331.13 | $426.58 |
Where New Hampshire sits
The same service costs 4.7 times more in Alaska than in Texas. 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
$661
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.