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 $758.58 Median $794.33 Typical High $851.14 | Professional | None | $758.58 | $794.33 | $851.14 |
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 $707.95 Median $1,318.26 Typical High $1,737.80 | Professional | None | $707.95 | $1,318.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $204.17 Typical High $269.15 | Professional | 80 · Assistant surgeon | $117.49 | $204.17 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $177.83 Typical High $239.88 | Professional | AS · PA/NP assist | $102.33 | $177.83 | $239.88 |
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 $812.83 Median $1,047.13 Typical High $1,995.26 | Professional | None | $812.83 | $1,047.13 | $1,995.26 |
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 $758.58 Median $1,096.48 Typical High $2,041.74 | Professional | None | $758.58 | $1,096.48 | $2,041.74 |
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 $758.58 Median $1,023.29 Typical High $2,041.74 | Professional | None | $758.58 | $1,023.29 | $2,041.74 |
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 $380.19 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $380.19 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $151.36 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $112.20 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $602.56 |
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· 14th of 51
$1,202
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.