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 $691.83 Median $776.25 Typical High $776.25 | Professional | None | $691.83 | $776.25 | $776.25 |
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 $912.01 Median $1,318.26 Typical High $1,862.09 | Professional | None | $912.01 | $1,318.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,995.26 Typical High $2,818.38 | Professional | 50 · Both sides | $1,318.26 | $1,995.26 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $213.80 Typical High $302.00 | Professional | 80 · Assistant surgeon | $138.04 | $213.80 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $186.21 Typical High $263.03 | Professional | AS · PA/NP assist | $123.03 | $186.21 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $6,456.54 Typical High $8,912.51 | Facility | None | $933.25 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $2,089.30 | Professional | None | $870.96 | $1,023.29 | $2,089.30 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $707.95 Median $1,047.13 Typical High $2,041.74 | Professional | None | $707.95 | $1,047.13 | $2,041.74 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,698.24 | Professional | None | $776.25 | $933.25 | $1,698.24 |
Well Sense Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $346.74 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $346.74 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $524.81 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $104.71 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $69.18 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $489.78 | $549.54 | $549.54 |
Where New Hampshire sits
The same service costs 7.8 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· 18th of 51
$1,096
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.