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 $309.03 Median $331.13 Typical High $9,772.37 | Facility | None | $309.03 | $331.13 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $776.25 | Professional | None | $309.03 | $331.13 | $776.25 |
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 $281.84 Median $426.58 Typical High $676.08 | Professional | None | $281.84 | $426.58 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $724.44 Typical High $1,348.96 | Professional | 50 · Both sides | $446.68 | $724.44 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $575.44 Typical High $851.14 | Facility | None | $457.09 | $575.44 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $512.86 Typical High $933.25 | Professional | None | $398.11 | $512.86 | $933.25 |
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 $363.08 Median $575.44 Typical High $1,122.02 | Professional | None | $363.08 | $575.44 | $1,122.02 |
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 $338.84 Median $457.09 Typical High $977.24 | Professional | None | $338.84 | $457.09 | $977.24 |
Well Sense Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
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 $154.88 Median $165.96 Typical High $257.04 | Professional | 52 · Reduced service | $154.88 | $165.96 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $66.07 Typical High $102.33 | Professional | 53 · Discontinued | $61.66 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $234.42 Typical High $251.19 | Professional | 54 · Surgery only | $218.78 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $48.98 Typical High $75.86 | Professional | 55 · Aftercare only | $46.77 | $48.98 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.11 Typical High $51.29 | Professional | 56 · Pre-op care only | $30.90 | $33.11 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $229.09 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $218.78 | $229.09 | $234.42 |
Where New Hampshire sits
The same service costs 5.8 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· 15th of 51
$479
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.