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 $2,630.27 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,630.27 | $3,090.30 | $3,090.30 |
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 $3,090.30 Median $4,570.88 Typical High $6,606.93 | Professional | None | $3,090.30 | $4,570.88 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,884.03 Typical High $4,168.69 | Professional | 62 · Two surgeons | $1,862.09 | $2,884.03 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $724.44 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $478.63 | $724.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $630.96 Typical High $933.25 | Professional | AS · PA/NP assist | $416.87 | $630.96 | $933.25 |
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 $2,951.21 Median $3,630.78 Typical High $7,413.10 | Professional | None | $2,951.21 | $3,630.78 | $7,413.10 |
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 $2,398.83 Median $3,548.13 Typical High $6,918.31 | Professional | None | $2,398.83 | $3,548.13 | $6,918.31 |
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 $2,754.23 Median $3,467.37 Typical High $6,918.31 | Professional | None | $2,754.23 | $3,467.37 | $6,918.31 |
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 $1,318.26 Median $1,548.82 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,318.26 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $524.81 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,995.26 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $398.11 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $309.03 Typical High $309.03 | Professional | 56 · Pre-op care only | $263.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,137.96 | $2,137.96 |
Where New Hampshire sits
The same service costs 25.7 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· 23rd of 51
$3,631
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.