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 $630.96 Median $741.31 Typical High $741.31 | Professional | None | $630.96 | $741.31 | $741.31 |
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 $831.76 Median $1,412.54 Typical High $1,949.84 | Professional | None | $831.76 | $1,412.54 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $2,137.96 Typical High $2,951.21 | Professional | 50 · Both sides | $1,380.38 | $2,137.96 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $223.87 Typical High $309.03 | Professional | 80 · Assistant surgeon | $147.91 | $223.87 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $199.53 Typical High $275.42 | Professional | AS · PA/NP assist | $128.82 | $199.53 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,162.28 Typical High $3,981.07 | Facility | None | $630.96 | $3,162.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,187.76 | Professional | None | $891.25 | $1,071.52 | $2,187.76 |
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 $741.31 Median $1,047.13 Typical High $1,905.46 | Professional | None | $741.31 | $1,047.13 | $1,905.46 |
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 $794.33 Median $977.24 Typical High $1,698.24 | Professional | None | $794.33 | $977.24 | $1,698.24 |
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 $316.23 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $467.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $512.86 |
Where New Hampshire sits
The same service costs 19.5 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· 19th of 51
$1,122
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.