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 $295.12 Median $389.05 Typical High $9,772.37 | Facility | None | $295.12 | $389.05 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $660.69 | Professional | None | $295.12 | $389.05 | $660.69 |
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 $251.19 Median $407.38 Typical High $537.03 | Professional | None | $251.19 | $407.38 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $81.28 Typical High $109.65 | Professional | 80 · Assistant surgeon | $53.70 | $81.28 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $47.86 Median $72.44 Typical High $95.50 | Professional | AS · PA/NP assist | $47.86 | $72.44 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $537.03 Typical High $707.95 | Facility | None | $100.00 | $537.03 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $1,047.13 | Professional | None | $363.08 | $562.34 | $1,047.13 |
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 $295.12 Median $489.78 Typical High $954.99 | Professional | None | $295.12 | $489.78 | $954.99 |
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 $331.13 Median $489.78 Typical High $851.14 | Professional | None | $331.13 | $489.78 | $851.14 |
Well Sense Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
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 $147.91 Median $162.18 Typical High $194.98 | Professional | 52 · Reduced service | $147.91 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $79.43 | Professional | 53 · Discontinued | $58.88 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $245.47 Typical High $295.12 | Professional | 54 · Surgery only | $223.87 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $58.88 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $229.09 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $208.93 | $229.09 | $275.42 |
Where New Hampshire sits
The same service costs 4.5 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· 17th 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.