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 $169.82 Median $194.98 Typical High $213.80 | Professional | None | $169.82 | $194.98 | $213.80 |
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 $208.93 Median $323.59 Typical High $389.05 | Professional | None | $208.93 | $323.59 | $389.05 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $562.34 Typical High $812.83 | Professional | 50 · Both sides | $416.87 | $562.34 | $812.83 |
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 $281.84 Median $371.54 Typical High $660.69 | Professional | None | $281.84 | $371.54 | $660.69 |
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 $223.87 Median $338.84 Typical High $676.08 | Professional | None | $223.87 | $338.84 | $676.08 |
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 $213.80 Median $316.23 Typical High $537.03 | Professional | None | $213.80 | $316.23 | $537.03 |
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 $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $85.11 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $38.90 Typical High $42.66 | Professional | 53 · Discontinued | $33.88 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $144.54 Typical High $162.18 | Professional | 54 · Surgery only | $125.89 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.84 Typical High $32.36 | Professional | 55 · Aftercare only | $25.12 | $28.84 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.50 Typical High $21.38 | Professional | 56 · Pre-op care only | $16.98 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $134.90 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $117.49 | $134.90 | $151.36 |
Where New Hampshire sits
The same service costs 5.0 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· 12th of 51
$324
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.