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 $3,890.45 Typical High $15,848.93 | Facility | None | $2,398.83 | $3,890.45 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,288.25 | $1,288.25 |
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 $1,412.54 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,412.54 | $2,137.96 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $3,235.94 Typical High $4,570.88 | Professional | 50 · Both sides | $2,089.30 | $3,235.94 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $338.84 Typical High $489.78 | Professional | 80 · Assistant surgeon | $223.87 | $338.84 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $302.00 Typical High $426.58 | Professional | AS · PA/NP assist | $194.98 | $302.00 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $8,912.51 Typical High $11,220.18 | Facility | None | $630.96 | $8,912.51 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $3,388.44 | Professional | None | $1,412.54 | $1,659.59 | $3,388.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,659.59 | $3,235.94 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $3,235.94 | Professional | None | $1,202.26 | $1,548.82 | $3,235.94 |
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 $512.86 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $776.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $154.88 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $102.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $724.44 | $912.01 | $912.01 |
Where New Hampshire sits
The same service costs 8.7 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· 17th of 51
$1,778
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.