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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | None | $398.11 | $436.52 | $436.52 |
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 $524.81 Median $794.33 Typical High $1,096.48 | Professional | None | $524.81 | $794.33 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,202.26 Typical High $1,621.81 | Professional | 50 · Both sides | $776.25 | $1,202.26 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $6,456.54 Typical High $8,912.51 | Facility | None | $660.69 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $602.56 Typical High $1,202.26 | Professional | None | $512.86 | $602.56 | $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 $426.58 Median $616.60 Typical High $1,202.26 | Professional | None | $426.58 | $616.60 | $1,202.26 |
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 $446.68 Median $549.54 Typical High $1,000.00 | Professional | None | $446.68 | $549.54 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $199.53 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $302.00 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $60.26 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $39.81 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $302.00 |
Where New Hampshire sits
The same service costs 7.2 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· 16th 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.