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 $141.25 Median $269.15 Typical High $331.13 | Professional | None | $141.25 | $269.15 | $331.13 |
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 $120.23 Median $245.47 Typical High $371.54 | Professional | None | $120.23 | $245.47 | $371.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $363.08 Typical High $707.95 | Professional | 50 · Both sides | $239.88 | $363.08 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,047.13 Typical High $1,513.56 | Facility | None | $575.44 | $1,047.13 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $371.54 Typical High $645.65 | Professional | None | $173.78 | $371.54 | $645.65 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $371.54 Typical High $851.14 | Professional | None | $177.83 | $371.54 | $851.14 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $173.78 Median $363.08 Typical High $794.33 | Professional | None | $173.78 | $363.08 | $794.33 |
Well Sense Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
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 $70.79 Median $134.90 Typical High $165.96 | Professional | 52 · Reduced service | $70.79 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $53.70 Typical High $67.61 | Professional | 53 · Discontinued | $28.18 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $204.17 Typical High $251.19 | Professional | 54 · Surgery only | $104.71 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $20.89 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $26.92 Typical High $33.11 | Professional | 56 · Pre-op care only | $14.13 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $190.55 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $97.72 | $190.55 | $234.42 |
Where New Hampshire sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 24th of 51
$282
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.