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 $2,344.23 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,344.23 | $2,691.53 | $2,691.53 |
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 $3,388.44 Median $5,248.07 Typical High $7,585.78 | Professional | None | $3,388.44 | $5,248.07 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $549.54 Median $831.76 Typical High $1,230.27 | Professional | 80 · Assistant surgeon | $549.54 | $831.76 | $1,230.27 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $478.63 Median $741.31 Typical High $1,071.52 | Professional | AS · PA/NP assist | $478.63 | $741.31 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $6,456.54 Typical High $8,912.51 | Facility | None | $812.83 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $3,388.44 Median $4,168.69 Typical High $8,511.38 | Professional | None | $3,388.44 | $4,168.69 | $8,511.38 |
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 $2,754.23 Median $4,168.69 Typical High $8,128.31 | Professional | None | $2,754.23 | $4,168.69 | $8,128.31 |
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 $3,019.95 Median $3,890.45 Typical High $6,918.31 | Professional | None | $3,019.95 | $3,890.45 | $6,918.31 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $1,174.90 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,174.90 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $467.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,778.28 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $354.81 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,905.46 | $1,905.46 |
Where New Hampshire sits
The same service costs 19.5 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· 15th of 51
$4,169
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.