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 $3,388.44 Typical High $14,791.08 | Facility | None | $2,398.83 | $3,388.44 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,754.23 | $3,090.30 | $3,090.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $10,000.00 Typical High $18,197.01 | Facility | None | $8,912.51 | $10,000.00 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $4,897.79 Typical High $7,079.46 | Professional | None | $3,162.28 | $4,897.79 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $3,090.30 Typical High $4,466.84 | Professional | 62 · Two surgeons | $1,995.26 | $3,090.30 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $776.25 Typical High $1,148.15 | Professional | 80 · Assistant surgeon | $512.86 | $776.25 | $1,148.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $446.68 Median $676.08 Typical High $1,000.00 | Professional | AS · PA/NP assist | $446.68 | $676.08 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $8,912.51 Typical High $11,220.18 | Facility | None | $630.96 | $8,912.51 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $3,162.28 Median $3,890.45 Typical High $7,943.28 | Professional | None | $3,162.28 | $3,890.45 | $7,943.28 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,570.40 Median $3,801.89 Typical High $6,760.83 | Professional | None | $2,570.40 | $3,801.89 | $6,760.83 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $3,090.30 Median $3,715.35 Typical High $6,760.83 | Professional | None | $3,090.30 | $3,715.35 | $6,760.83 |
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 $1,380.38 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,380.38 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,041.74 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $407.38 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,137.96 | $2,137.96 |
Where New Hampshire sits
The same service costs 8.7 times more in Alaska than in Texas. 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
$3,890
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.