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 $1,348.96 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $10,000.00 Typical High $18,197.01 | Facility | None | $8,912.51 | $10,000.00 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,691.53 Typical High $3,715.35 | Professional | None | $1,584.89 | $2,691.53 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $436.52 Typical High $602.56 | Professional | 80 · Assistant surgeon | $281.84 | $436.52 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $380.19 Typical High $524.81 | Professional | AS · PA/NP assist | $245.47 | $380.19 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $6,456.54 Typical High $8,912.51 | Facility | None | $660.69 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,041.74 Typical High $4,168.69 | Professional | None | $1,778.28 | $2,041.74 | $4,168.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,445.44 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,445.44 | $2,137.96 | $4,168.69 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,698.24 | $1,995.26 | $3,388.44 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $676.08 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $676.08 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $269.15 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,023.29 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $204.17 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $134.90 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $954.99 | $1,096.48 | $1,096.48 |
Where New Hampshire sits
The same service costs 17.0 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
$2,188
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.