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 $645.65 Median $724.44 Typical High $724.44 | Professional | None | $645.65 | $724.44 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $5,248.07 Typical High $11,481.54 | Facility | None | $3,467.37 | $5,248.07 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,737.80 | Professional | None | $954.99 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,862.09 Typical High $2,630.27 | Professional | 50 · Both sides | $1,230.27 | $1,862.09 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,884.03 Typical High $3,981.07 | Facility | None | $660.69 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,949.84 | Professional | None | $812.83 | $954.99 | $1,949.84 |
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 $660.69 Median $977.24 Typical High $1,905.46 | Professional | None | $660.69 | $977.24 | $1,905.46 |
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 $707.95 Median $870.96 Typical High $1,621.81 | Professional | None | $707.95 | $870.96 | $1,621.81 |
Well Sense Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $331.13 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $331.13 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $489.78 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $512.86 |
Where New Hampshire sits
The same service costs 7.4 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
$1,047
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.