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 $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | None | $676.08 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,380.38 Typical High $1,905.46 | Professional | None | $812.83 | $1,380.38 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,041.74 Typical High $2,884.03 | Professional | 50 · Both sides | $1,348.96 | $2,041.74 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $218.78 Typical High $309.03 | Professional | 80 · Assistant surgeon | $169.82 | $218.78 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $190.55 Typical High $269.15 | Professional | AS · PA/NP assist | $125.89 | $190.55 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,079.46 Typical High $8,912.51 | Facility | None | $630.96 | $7,079.46 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,137.96 | Professional | None | $891.25 | $1,047.13 | $2,137.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,862.09 | Professional | None | $724.44 | $1,096.48 | $1,862.09 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,778.28 | Professional | None | $870.96 | $1,122.02 | $1,778.28 |
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 $338.84 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $501.19 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $102.33 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $467.74 | $588.84 | $588.84 |
Where New Hampshire sits
The same service costs 8.7 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· 17th of 51
$1,148
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.