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 $3,388.44 Typical High $14,791.08 | Facility | None | $2,398.83 | $3,388.44 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $691.83 | Professional | None | $588.84 | $691.83 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $11,481.54 | Facility | None | $1,513.56 | $1,737.80 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $1,698.24 | Professional | None | $794.33 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,862.09 Typical High $2,570.40 | Professional | 50 · Both sides | $1,202.26 | $1,862.09 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $776.25 Typical High $1,071.52 | Professional | 62 · Two surgeons | $501.19 | $776.25 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,659.59 Typical High $2,454.71 | Facility | None | $812.83 | $1,659.59 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,905.46 | Professional | None | $794.33 | $933.25 | $1,905.46 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,862.09 | Professional | None | $645.65 | $954.99 | $1,862.09 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,513.56 | Professional | None | $660.69 | $851.14 | $1,513.56 |
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 $316.23 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $478.63 |
Where New Hampshire sits
The same service costs 7.2 times more in Alaska than in Utah. 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
$1,000
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.