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 $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $933.25 | $1,047.13 | $1,047.13 |
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 $1,318.26 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,778.28 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,630.27 Typical High $3,715.35 | Professional | 50 · Both sides | $1,737.80 | $2,630.27 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $281.84 Typical High $398.11 | Professional | 80 · Assistant surgeon | $186.21 | $281.84 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $245.47 Typical High $346.74 | Professional | AS · PA/NP assist | $162.18 | $245.47 | $346.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $2,754.23 | Professional | None | $933.25 | $1,412.54 | $2,754.23 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,258.93 | $2,290.87 |
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 $467.74 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $645.65 | $741.31 | $741.31 |
Where New Hampshire sits
The same service costs 17.4 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· 14th of 51
$1,514
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.