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 $549.54 Median $691.83 Typical High $691.83 | Professional | None | $549.54 | $691.83 | $691.83 |
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 $616.60 Median $1,023.29 Typical High $1,445.44 | Professional | None | $616.60 | $1,023.29 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $165.96 Typical High $229.09 | Professional | 80 · Assistant surgeon | $107.15 | $165.96 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $93.33 | $144.54 | $204.17 |
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 $676.08 Median $794.33 Typical High $1,621.81 | Professional | None | $676.08 | $794.33 | $1,621.81 |
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 $549.54 Median $870.96 Typical High $1,584.89 | Professional | None | $549.54 | $870.96 | $1,584.89 |
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 $691.83 Median $912.01 Typical High $1,445.44 | Professional | None | $691.83 | $912.01 | $1,445.44 |
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 $269.15 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $269.15 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $109.65 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $407.38 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $81.28 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $54.95 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $489.78 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $380.19 | $489.78 | $489.78 |
Where New Hampshire sits
The same service costs 6.6 times more in Alaska than in Utah. 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
$933
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.