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 $741.31 Median $758.58 Typical High $891.25 | Professional | None | $741.31 | $758.58 | $891.25 |
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 $575.44 Median $912.01 Typical High $1,148.15 | Professional | None | $575.44 | $912.01 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $169.82 Typical High $251.19 | Professional | 80 · Assistant surgeon | $123.03 | $169.82 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $147.91 Typical High $223.87 | Professional | AS · PA/NP assist | $125.89 | $147.91 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,248.07 Typical High $7,244.36 | Facility | None | $812.83 | $5,248.07 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $2,238.72 | Professional | None | $851.14 | $1,148.15 | $2,238.72 |
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 $660.69 Median $1,047.13 Typical High $1,995.26 | Professional | None | $660.69 | $1,047.13 | $1,995.26 |
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 $741.31 Median $1,071.52 Typical High $1,905.46 | Professional | None | $741.31 | $1,071.52 | $1,905.46 |
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 $371.54 Median $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $151.36 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $630.96 |
Where New Hampshire sits
The same service costs 6.6 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· 23rd of 51
$933
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.