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 $676.08 Median $831.76 Typical High $831.76 | Professional | None | $676.08 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $5,623.41 Typical High $9,332.54 | Facility | None | $5,011.87 | $5,623.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,995.26 | Professional | None | $954.99 | $1,445.44 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $229.09 Typical High $323.59 | Professional | 80 · Assistant surgeon | $151.36 | $229.09 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $204.17 Typical High $281.84 | Professional | AS · PA/NP assist | $131.83 | $204.17 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $5,248.07 Typical High $7,244.36 | Facility | None | $1,288.25 | $5,248.07 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,290.87 | Professional | None | $912.01 | $1,122.02 | $2,290.87 |
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 $776.25 Median $1,148.15 Typical High $2,238.72 | Professional | None | $776.25 | $1,148.15 | $2,238.72 |
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 $831.76 Median $1,071.52 Typical High $1,905.46 | Professional | None | $831.76 | $1,071.52 | $1,905.46 |
Well Sense Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $338.84 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $478.63 | $588.84 | $588.84 |
Where New Hampshire sits
The same service costs 17.4 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
$1,202
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.