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 $691.83 Typical High $691.83 | Professional | None | $630.96 | $691.83 | $691.83 |
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 $758.58 Median $1,258.93 Typical High $1,737.80 | Professional | None | $758.58 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $128.82 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $173.78 Typical High $245.47 | Professional | AS · PA/NP assist | $114.82 | $173.78 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,659.59 Typical High $2,187.76 | Facility | None | $575.44 | $1,659.59 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,949.84 | Professional | None | $758.58 | $954.99 | $1,949.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,905.46 | Professional | None | $660.69 | $977.24 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,584.89 | Professional | None | $588.84 | $870.96 | $1,584.89 |
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 $316.23 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $125.89 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $478.63 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $63.10 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $446.68 | $478.63 | $478.63 |
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· 14th of 51
$1,000
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.