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 $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
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 $1,905.46 Median $3,019.95 Typical High $4,365.16 | Professional | None | $1,905.46 | $3,019.95 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,905.46 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,230.27 | $1,905.46 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $478.63 Typical High $691.83 | Professional | 80 · Assistant surgeon | $316.23 | $478.63 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $416.87 Typical High $602.56 | Professional | AS · PA/NP assist | $275.42 | $416.87 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,244.36 Typical High $9,120.11 | Facility | None | $630.96 | $7,244.36 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $4,897.79 | Professional | None | $1,949.84 | $2,398.83 | $4,897.79 |
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 $1,584.89 Median $2,344.23 Typical High $4,265.80 | Professional | None | $1,584.89 | $2,344.23 | $4,265.80 |
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 $1,737.80 Median $2,238.72 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,238.72 | $4,265.80 |
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 $794.33 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $794.33 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $316.23 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,174.90 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $234.42 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,380.38 | $1,380.38 |
Where New Hampshire sits
The same service costs 19.5 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· 19th of 51
$2,455
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.