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 $2,238.72 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,238.72 | $2,511.89 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $10,000.00 Typical High $18,197.01 | Facility | None | $8,912.51 | $10,000.00 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $3,981.07 Typical High $5,754.40 | Professional | None | $2,691.53 | $3,981.07 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $2,511.89 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,621.81 | $2,511.89 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $416.87 Median $630.96 Typical High $933.25 | Professional | 80 · Assistant surgeon | $416.87 | $630.96 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $549.54 Typical High $812.83 | Professional | AS · PA/NP assist | $363.08 | $549.54 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $17,782.79 Typical High $22,387.21 | Facility | None | $630.96 | $17,782.79 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,162.28 Typical High $6,456.54 | Professional | None | $2,570.40 | $3,162.28 | $6,456.54 |
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 $2,089.30 Median $3,090.30 Typical High $5,495.41 | Professional | None | $2,089.30 | $3,090.30 | $5,495.41 |
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 $2,454.71 Median $3,019.95 Typical High $5,495.41 | Professional | None | $2,454.71 | $3,019.95 | $5,495.41 |
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 $1,122.02 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,122.02 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,659.59 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,778.28 | $1,778.28 |
Where New Hampshire sits
The same service costs 6.5 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· 20th of 51
$3,236
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.