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 $1,071.52 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,096.48 | $1,258.93 |
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 $1,230.27 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $295.12 Typical High $389.05 | Professional | 80 · Assistant surgeon | $177.83 | $295.12 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $257.04 Typical High $338.84 | Professional | AS · PA/NP assist | $154.88 | $257.04 | $338.84 |
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 $1,174.90 Median $1,513.56 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,513.56 | $2,818.38 |
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 $1,071.52 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,071.52 | $1,548.82 | $2,884.03 |
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 $1,148.15 Median $1,513.56 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,513.56 | $2,884.03 |
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 $537.03 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $537.03 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $218.78 Typical High $229.09 | Professional | 53 · Discontinued | $213.80 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $109.65 Typical High $114.82 | Professional | 56 · Pre-op care only | $107.15 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $812.83 |
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
$1,660
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.