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 $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,995.26 | $2,238.72 | $2,238.72 |
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 $3,162.28 Median $4,168.69 Typical High $6,025.60 | Professional | None | $3,162.28 | $4,168.69 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $2,630.27 Typical High $3,801.89 | Professional | 62 · Two surgeons | $1,737.80 | $2,630.27 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $676.08 Typical High $954.99 | Professional | 80 · Assistant surgeon | $436.52 | $676.08 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $588.84 Typical High $851.14 | Professional | AS · PA/NP assist | $380.19 | $588.84 | $851.14 |
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 $2,754.23 Median $3,311.31 Typical High $6,760.83 | Professional | None | $2,754.23 | $3,311.31 | $6,760.83 |
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 $2,238.72 Median $3,311.31 Typical High $6,456.54 | Professional | None | $2,238.72 | $3,311.31 | $6,456.54 |
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 $2,398.83 Median $3,162.28 Typical High $5,495.41 | Professional | None | $2,398.83 | $3,162.28 | $5,495.41 |
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 $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,000.00 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,479.11 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,548.82 | $1,548.82 |
Where New Hampshire sits
The same service costs 21.4 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· 15th 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.