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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | None | $549.54 | $616.60 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $3,467.37 | Facility | None | $1,288.25 | $1,548.82 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,479.11 | Professional | None | $691.83 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $676.08 Typical High $933.25 | Professional | 62 · Two surgeons | $436.52 | $676.08 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $169.82 Typical High $239.88 | Professional | 80 · Assistant surgeon | $112.20 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $147.91 Typical High $208.93 | Professional | AS · PA/NP assist | $97.72 | $147.91 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $741.31 Typical High $1,096.48 | Facility | None | $588.84 | $741.31 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,659.59 | Professional | None | $707.95 | $812.83 | $1,659.59 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $660.69 Median $776.25 Typical High $2,691.53 | Facility | None | $660.69 | $776.25 | $2,691.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,621.81 | Professional | None | $562.34 | $831.76 | $1,621.81 |
United Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $2,691.53 | Facility | None | $660.69 | $851.14 | $2,691.53 |
United Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $1,348.96 | Professional | None | $616.60 | $741.31 | $1,348.96 |
Well Sense Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
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 $275.42 Median $309.03 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 53 · Discontinued | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $407.38 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | 56 · Pre-op care only | $54.95 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $380.19 | $436.52 | $436.52 |
Where New Hampshire sits
The same service costs 6.3 times more in Alaska than in Utah. 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
$813
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.