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 $251.19 Median $371.54 Typical High $562.34 | Professional | None | $251.19 | $371.54 | $562.34 |
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 $199.53 Median $380.19 Typical High $616.60 | Professional | None | $199.53 | $380.19 | $616.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $602.56 Typical High $1,174.90 | Professional | 50 · Both sides | $407.38 | $602.56 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $489.78 Typical High $1,174.90 | Facility | None | $371.54 | $489.78 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $537.03 Typical High $912.01 | Professional | None | $281.84 | $537.03 | $912.01 |
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 $309.03 Median $524.81 Typical High $1,202.26 | Professional | None | $309.03 | $524.81 | $1,202.26 |
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 $302.00 Median $501.19 Typical High $1,071.52 | Professional | None | $302.00 | $501.19 | $1,071.52 |
Well Sense Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
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 $123.03 Median $186.21 Typical High $281.84 | Professional | 52 · Reduced service | $123.03 | $186.21 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $74.13 Typical High $114.82 | Professional | 53 · Discontinued | $50.12 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $275.42 Typical High $426.58 | Professional | 54 · Surgery only | $186.21 | $275.42 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $54.95 Typical High $85.11 | Professional | 55 · Aftercare only | $37.15 | $54.95 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $37.15 Typical High $56.23 | Professional | 56 · Pre-op care only | $25.12 | $37.15 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $257.04 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $173.78 | $257.04 | $398.11 |
Where New Hampshire sits
The same service costs 3.9 times more in Wyoming 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· 18th of 51
$437
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.