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 $5,370.32 Typical High $22,387.21 | Facility | None | $2,398.83 | $5,370.32 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $912.01 | Professional | None | $691.83 | $758.58 | $912.01 |
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 $489.78 Median $776.25 Typical High $977.24 | Professional | None | $489.78 | $776.25 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $144.54 Typical High $223.87 | Professional | 80 · Assistant surgeon | $123.03 | $144.54 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $125.89 Typical High $194.98 | Professional | AS · PA/NP assist | $91.20 | $125.89 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $5,248.07 | Facility | None | $1,288.25 | $4,073.80 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $1,905.46 | Professional | None | $741.31 | $954.99 | $1,905.46 |
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 $575.44 Median $933.25 Typical High $1,737.80 | Professional | None | $575.44 | $933.25 | $1,737.80 |
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 $724.44 Median $933.25 Typical High $1,698.24 | Professional | None | $724.44 | $933.25 | $1,698.24 |
Well Sense Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
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 $346.74 Median $380.19 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $575.44 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $114.82 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $537.03 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $537.03 | $645.65 |
Where New Hampshire sits
The same service costs 6.2 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· 25th of 51
$832
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.