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 $691.83 Median $758.58 Typical High $758.58 | Professional | None | $691.83 | $758.58 | $758.58 |
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 $891.25 Median $1,348.96 Typical High $1,905.46 | Professional | None | $891.25 | $1,348.96 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,041.74 Typical High $2,884.03 | Professional | 50 · Both sides | $1,348.96 | $2,041.74 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $218.78 Typical High $302.00 | Professional | 80 · Assistant surgeon | $141.25 | $218.78 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $190.55 Typical High $269.15 | Professional | AS · PA/NP assist | $125.89 | $190.55 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,715.35 Typical High $5,128.61 | Facility | None | $660.69 | $3,715.35 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,137.96 | Professional | None | $891.25 | $1,047.13 | $2,137.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $724.44 Median $1,071.52 Typical High $2,089.30 | Professional | None | $724.44 | $1,071.52 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,698.24 | Professional | None | $776.25 | $954.99 | $1,698.24 |
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 $338.84 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $338.84 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $512.86 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $69.18 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $478.63 | $537.03 | $537.03 |
Where New Hampshire sits
The same service costs 8.5 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· 11th of 51
$1,148
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.