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 $2,398.83 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,398.83 | $2,630.27 | $2,630.27 |
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 $2,630.27 Median $4,168.69 Typical High $6,165.95 | Professional | None | $2,630.27 | $4,168.69 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $2,630.27 Typical High $3,890.45 | Professional | 62 · Two surgeons | $1,698.24 | $2,630.27 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $660.69 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $436.52 | $660.69 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $575.44 Typical High $870.96 | Professional | AS · PA/NP assist | $380.19 | $575.44 | $870.96 |
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 $2,754.23 Median $3,388.44 Typical High $6,918.31 | Professional | None | $2,754.23 | $3,388.44 | $6,918.31 |
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 $2,187.76 Median $3,235.94 Typical High $5,623.41 | Professional | None | $2,187.76 | $3,235.94 | $5,623.41 |
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 $2,630.27 Median $3,235.94 Typical High $5,623.41 | Professional | None | $2,630.27 | $3,235.94 | $5,623.41 |
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 $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,174.90 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $478.63 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,778.28 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $354.81 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $1,819.70 |
Where New Hampshire sits
The same service costs 21.9 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
$3,388
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.