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 $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $446.68 | Professional | None | $363.08 | $363.08 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $660.69 Typical High $912.01 | Professional | None | $436.52 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $416.87 Typical High $562.34 | Professional | 62 · Two surgeons | $234.42 | $416.87 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,511.89 Typical High $3,467.37 | Facility | None | $575.44 | $2,511.89 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $707.95 Typical High $977.24 | Professional | None | $457.09 | $707.95 | $977.24 |
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 $407.38 Median $549.54 Typical High $1,071.52 | Professional | None | $407.38 | $549.54 | $1,071.52 |
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 $380.19 Median $512.86 Typical High $1,000.00 | Professional | None | $380.19 | $512.86 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Facility | None | $933.25 | $933.25 | $933.25 |
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 $181.97 Median $181.97 Typical High $218.78 | Professional | 52 · Reduced service | $181.97 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | 53 · Discontinued | $72.44 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $275.42 Typical High $323.59 | Professional | 54 · Surgery only | $269.15 | $275.42 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $53.70 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $43.65 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $257.04 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $251.19 | $257.04 | $302.00 |
Where New Hampshire sits
The same service costs 5.1 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· 13th of 51
$646
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.