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 $758.58 Median $851.14 Typical High $851.14 | Professional | None | $758.58 | $851.14 | $851.14 |
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 $1,023.29 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $263.03 Typical High $354.81 | Professional | 80 · Assistant surgeon | $169.82 | $263.03 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $229.09 Typical High $309.03 | Professional | AS · PA/NP assist | $151.36 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,884.03 Typical High $3,981.07 | Facility | None | $575.44 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,230.27 | $2,511.89 |
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 $870.96 Median $1,230.27 Typical High $2,454.71 | Professional | None | $870.96 | $1,230.27 | $2,454.71 |
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 $870.96 Median $1,096.48 Typical High $1,905.46 | Professional | None | $870.96 | $1,096.48 | $1,905.46 |
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 $380.19 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $602.56 |
Where New Hampshire sits
The same service costs 8.3 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· 16th of 51
$1,259
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.