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 $1,445.44 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,445.44 | $1,698.24 | $1,698.24 |
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 $1,737.80 Median $2,630.27 Typical High $3,801.89 | Professional | None | $1,737.80 | $2,630.27 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,659.59 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,096.48 | $1,659.59 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $416.87 Typical High $602.56 | Professional | 80 · Assistant surgeon | $275.42 | $416.87 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $371.54 Typical High $524.81 | Professional | AS · PA/NP assist | $239.88 | $371.54 | $524.81 |
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 $1,737.80 Median $2,089.30 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,089.30 | $4,265.80 |
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 $1,412.54 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,412.54 | $2,041.74 | $3,715.35 |
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 $1,584.89 Median $1,949.84 Typical High $3,715.35 | Professional | None | $1,584.89 | $1,949.84 | $3,715.35 |
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 $724.44 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $724.44 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $288.40 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,096.48 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $218.78 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,202.26 | $1,202.26 |
Where New Hampshire sits
The same service costs 17.8 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· 18th of 51
$2,188
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.