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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | None | $616.60 | $724.44 | $724.44 |
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 $776.25 Median $1,412.54 Typical High $1,819.70 | Professional | None | $776.25 | $1,412.54 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $223.87 Typical High $295.12 | Professional | 80 · Assistant surgeon | $147.91 | $223.87 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $194.98 Typical High $257.04 | Professional | AS · PA/NP assist | $128.82 | $194.98 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,884.03 Typical High $3,981.07 | Facility | None | $537.03 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $2,089.30 | Professional | None | $891.25 | $1,023.29 | $2,089.30 |
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 $741.31 Median $1,047.13 Typical High $2,089.30 | Professional | None | $741.31 | $1,047.13 | $2,089.30 |
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 $794.33 Median $954.99 Typical High $1,621.81 | Professional | None | $794.33 | $954.99 | $1,621.81 |
Well Sense Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $309.03 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $457.09 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $91.20 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $426.58 | $501.19 | $501.19 |
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· 15th 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.