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 $4,466.84 Typical High $20,892.96 | Facility | None | $2,398.83 | $4,466.84 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,995.26 | $2,187.76 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $27,542.29 Median $30,902.95 Typical High $37,153.52 | Facility | None | $27,542.29 | $30,902.95 | $37,153.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $3,981.07 Typical High $5,370.32 | Professional | None | $2,344.23 | $3,981.07 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $2,511.89 Typical High $3,388.44 | Professional | 62 · Two surgeons | $1,659.59 | $2,511.89 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $645.65 Typical High $851.14 | Professional | 80 · Assistant surgeon | $416.87 | $645.65 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $562.34 Typical High $758.58 | Professional | AS · PA/NP assist | $371.54 | $562.34 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $18,197.01 Typical High $22,908.68 | Facility | None | $630.96 | $18,197.01 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $5,888.44 | Professional | None | $2,570.40 | $2,884.03 | $5,888.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $10,964.78 | Facility | None | $2,884.03 | $4,168.69 | $10,964.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,137.96 Median $3,090.30 Typical High $6,025.60 | Professional | None | $2,137.96 | $3,090.30 | $6,025.60 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $5,754.40 Typical High $10,964.78 | Facility | None | $2,884.03 | $5,754.40 | $10,964.78 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $4,897.79 | Professional | None | $2,137.96 | $2,691.53 | $4,897.79 |
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 $1,000.00 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $398.11 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,513.56 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $199.53 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,548.82 | $1,548.82 |
Where New Hampshire sits
The same service costs 16.2 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· 18th of 51
$3,090
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.