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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | None | $602.56 | $724.44 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,659.59 | Professional | None | $776.25 | $1,174.90 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,778.28 Typical High $2,454.71 | Professional | 50 · Both sides | $1,148.15 | $1,778.28 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $190.55 Typical High $263.03 | Professional | 80 · Assistant surgeon | $123.03 | $190.55 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $165.96 Typical High $229.09 | Professional | AS · PA/NP assist | $107.15 | $165.96 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $1,659.59 Typical High $2,187.76 | Facility | None | $660.69 | $1,659.59 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,819.70 | Professional | None | $776.25 | $912.01 | $1,819.70 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,778.28 | Professional | None | $630.96 | $977.24 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,479.11 | Professional | None | $758.58 | $1,000.00 | $1,479.11 |
Well Sense Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
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 $295.12 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $295.12 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $120.23 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $60.26 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $416.87 | $501.19 | $501.19 |
Where New Hampshire sits
The same service costs 7.4 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
$1,023
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.