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 $891.25 Median $1,000.00 Typical High $1,096.48 | Professional | None | $891.25 | $1,000.00 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $263.03 Typical High $346.74 | Professional | 80 · Assistant surgeon | $162.18 | $263.03 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $229.09 Typical High $302.00 | Professional | AS · PA/NP assist | $141.25 | $229.09 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $2,818.38 Typical High $3,715.35 | Facility | None | $933.25 | $2,818.38 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,348.96 | $2,511.89 |
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 $954.99 Median $1,380.38 Typical High $2,570.40 | Professional | None | $954.99 | $1,380.38 | $2,570.40 |
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 $1,348.96 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,348.96 | $2,511.89 |
Well Sense Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $891.25 | Facility | None | $891.25 | $891.25 | $891.25 |
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 $436.52 Median $501.19 Typical High $524.81 | Professional | 52 · Reduced service | $436.52 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $199.53 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $758.58 Typical High $776.25 | Professional | 54 · Surgery only | $660.69 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $151.36 Typical High $158.49 | Professional | 55 · Aftercare only | $131.83 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $707.95 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $616.60 | $707.95 | $724.44 |
Where New Hampshire sits
The same service costs 6.2 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· 15th 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.