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 $1,288.25 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,288.25 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $11,481.54 Typical High $19,952.62 | Facility | None | $9,332.54 | $11,481.54 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,584.89 | $2,454.71 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $3,630.78 Typical High $5,248.07 | Professional | 50 · Both sides | $2,398.83 | $3,630.78 | $5,248.07 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $16,595.87 Typical High $20,892.96 | Facility | None | $630.96 | $16,595.87 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $3,890.45 | Professional | None | $1,584.89 | $1,905.46 | $3,890.45 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,288.25 | $1,949.84 | $3,801.89 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,778.28 | $3,235.94 |
Well Sense Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,244.36 | Facility | None | $7,244.36 | $7,244.36 | $7,244.36 |
4 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 54 · Surgery only Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $977.24 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $912.01 | $1,023.29 | $1,023.29 |
Where New Hampshire sits
The same service costs 8.1 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
$2,042
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.