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 $1,584.89 Median $2,398.83 Typical High $14,791.08 | Facility | None | $1,584.89 | $2,398.83 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,380.38 | $1,584.89 | $1,584.89 |
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 $1,621.81 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,621.81 | $2,511.89 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,584.89 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,023.29 | $1,584.89 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $398.11 Typical High $575.44 | Professional | 80 · Assistant surgeon | $263.03 | $398.11 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $346.74 Typical High $501.19 | Professional | AS · PA/NP assist | $229.09 | $346.74 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,754.40 Typical High $7,244.36 | Facility | None | $630.96 | $5,754.40 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,659.59 | $1,949.84 | $3,981.07 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $3,467.37 | Professional | None | $1,318.26 | $1,949.84 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,819.70 | $3,467.37 |
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 $691.83 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $275.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,047.13 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $977.24 | $1,122.02 | $1,122.02 |
Where New Hampshire sits
The same service costs 15.1 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· 20th of 51
$2,089
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.