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 $1,202.26 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,318.26 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $5,623.41 Typical High $9,332.54 | Facility | None | $5,011.87 | $5,623.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,071.52 | $1,995.26 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $371.54 Typical High $676.08 | Professional | 80 · Assistant surgeon | $257.04 | $371.54 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $323.59 Typical High $588.84 | Professional | AS · PA/NP assist | $229.09 | $323.59 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $5,248.07 Typical High $7,244.36 | Facility | None | $933.25 | $5,248.07 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $4,570.88 | Professional | None | $1,513.56 | $2,290.87 | $4,570.88 |
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 $1,348.96 Median $2,398.83 Typical High $5,370.32 | Professional | None | $1,348.96 | $2,398.83 | $5,370.32 |
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 $1,513.56 Median $2,089.30 Typical High $4,466.84 | Professional | None | $1,513.56 | $2,089.30 | $4,466.84 |
Well Sense Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $602.56 Median $660.69 Typical High $724.44 | Professional | 52 · Reduced service | $602.56 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $263.03 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $977.24 Typical High $1,096.48 | Professional | 54 · Surgery only | $912.01 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $218.78 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $131.83 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $912.01 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $851.14 | $912.01 | $1,023.29 |
Where New Hampshire sits
The same service costs 5.2 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
$2,089
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.