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 $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,621.81 | $1,737.80 | $1,737.80 |
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 $2,238.72 Median $3,630.78 Typical High $4,786.30 | Professional | None | $2,238.72 | $3,630.78 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $2,290.87 Typical High $3,019.95 | Professional | 62 · Two surgeons | $1,513.56 | $2,290.87 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $588.84 Typical High $776.25 | Professional | 80 · Assistant surgeon | $380.19 | $588.84 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $512.86 Typical High $676.08 | Professional | AS · PA/NP assist | $338.84 | $512.86 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,079.46 Typical High $8,912.51 | Facility | None | $630.96 | $7,079.46 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $2,630.27 Typical High $5,370.32 | Professional | None | $2,290.87 | $2,630.27 | $5,370.32 |
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 $1,949.84 Median $2,691.53 Typical High $4,897.79 | Professional | None | $1,949.84 | $2,691.53 | $4,897.79 |
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 $1,737.80 Median $2,398.83 Typical High $4,168.69 | Professional | None | $1,737.80 | $2,398.83 | $4,168.69 |
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 $812.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $323.59 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,202.26 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,202.26 | $1,202.26 |
Where New Hampshire sits
The same service costs 11.2 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· 13th of 51
$2,818
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.