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 $1,698.24 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,698.24 | $1,949.84 | $1,949.84 |
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 $1,862.09 Median $2,951.21 Typical High $4,365.16 | Professional | None | $1,862.09 | $2,951.21 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $467.74 Typical High $691.83 | Professional | 80 · Assistant surgeon | $309.03 | $467.74 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $407.38 Typical High $616.60 | Professional | AS · PA/NP assist | $316.23 | $407.38 | $616.60 |
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 $1,548.82 Median $2,344.23 Typical High $4,677.35 | Professional | None | $1,548.82 | $2,344.23 | $4,677.35 |
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 $1,949.84 Median $2,344.23 Typical High $4,365.16 | Professional | None | $1,949.84 | $2,344.23 | $4,365.16 |
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 $851.14 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $851.14 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,288.25 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,348.96 | $1,348.96 |
Where New Hampshire sits
The same service costs 20.4 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· 20th 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.