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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $616.60 | Professional | None | $281.84 | $331.13 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $676.08 | Professional | None | $204.17 | $316.23 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $398.11 Median $588.84 Typical High $1,047.13 | Professional | 50 · Both sides | $398.11 | $588.84 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $575.44 | Facility | None | $295.12 | $389.05 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $457.09 Typical High $741.31 | Professional | None | $288.40 | $457.09 | $741.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,691.53 | Facility | None | $660.69 | $776.25 | $2,691.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $954.99 | Professional | None | $323.59 | $501.19 | $954.99 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,691.53 | Facility | None | $660.69 | $851.14 | $2,691.53 |
United Setting Professional Modifier None Typical Low $323.59 Median $457.09 Typical High $870.96 | Professional | None | $323.59 | $457.09 | $870.96 |
Well Sense Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
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 $141.25 Median $165.96 Typical High $229.09 | Professional | 52 · Reduced service | $141.25 | $165.96 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $66.07 Typical High $93.33 | Professional | 53 · Discontinued | $56.23 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $251.19 Typical High $346.74 | Professional | 54 · Surgery only | $208.93 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $50.12 Typical High $69.18 | Professional | 55 · Aftercare only | $41.69 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.11 Typical High $45.71 | Professional | 56 · Pre-op care only | $28.18 | $33.11 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $234.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $194.98 | $234.42 | $323.59 |
Where New Hampshire sits
The same service costs 4.2 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
$398
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.