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 $1,071.52 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,071.52 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,548.82 | $2,041.74 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,288.25 Typical High $1,778.28 | Professional | 62 · Two surgeons | $851.14 | $1,288.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $331.13 Typical High $446.68 | Professional | 80 · Assistant surgeon | $213.80 | $331.13 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $288.40 Typical High $389.05 | Professional | AS · PA/NP assist | $186.21 | $288.40 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $8,912.51 Typical High $11,220.18 | Facility | None | $630.96 | $8,912.51 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,479.11 | $3,019.95 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,096.48 | $1,584.89 | $2,754.23 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,174.90 | $1,445.44 | $2,570.40 |
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 $524.81 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $524.81 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $851.14 | $851.14 |
Where New Hampshire sits
The same service costs 14.8 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· 14th of 51
$1,698
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.