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 $933.25 Median $1,202.26 Typical High $1,202.26 | Professional | None | $933.25 | $1,202.26 | $1,202.26 |
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 $1,380.38 Median $2,137.96 Typical High $3,019.95 | Professional | None | $1,380.38 | $2,137.96 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $3,162.28 Typical High $4,466.84 | Professional | 50 · Both sides | $2,089.30 | $3,162.28 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $338.84 Typical High $478.63 | Professional | 80 · Assistant surgeon | $223.87 | $338.84 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $295.12 Typical High $416.87 | Professional | AS · PA/NP assist | $194.98 | $295.12 | $416.87 |
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 $1,380.38 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,380.38 | $1,659.59 | $3,311.31 |
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 $3,311.31 | Professional | None | $1,122.02 | $1,659.59 | $3,311.31 |
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 $1,513.56 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,513.56 | $2,691.53 |
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 $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $467.74 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $186.21 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $707.95 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $141.25 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $660.69 | $851.14 | $851.14 |
Where New Hampshire sits
The same service costs 13.8 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
$1,738
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.