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 $3,890.45 Typical High $15,848.93 | Facility | None | $2,398.83 | $3,890.45 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | None | $724.44 | $870.96 | $870.96 |
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 $954.99 Median $1,445.44 Typical High $2,089.30 | Professional | None | $954.99 | $1,445.44 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $2,187.76 Typical High $3,090.30 | Professional | 50 · Both sides | $1,412.54 | $2,187.76 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $234.42 Typical High $331.13 | Professional | 80 · Assistant surgeon | $151.36 | $234.42 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $204.17 Typical High $288.40 | Professional | AS · PA/NP assist | $131.83 | $204.17 | $288.40 |
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 $954.99 Median $1,148.15 Typical High $2,290.87 | Professional | None | $954.99 | $1,148.15 | $2,290.87 |
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 $776.25 Median $1,148.15 Typical High $2,238.72 | Professional | None | $776.25 | $1,148.15 | $2,238.72 |
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 $891.25 Median $1,071.52 Typical High $1,905.46 | Professional | None | $891.25 | $1,071.52 | $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 $363.08 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $549.54 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $109.65 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $512.86 | $616.60 | $616.60 |
Where New Hampshire sits
The same service costs 16.6 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
$1,202
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.