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 $3,388.44 Typical High $14,791.08 | Facility | None | $2,398.83 | $3,388.44 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $870.96 | Professional | None | $707.95 | $870.96 | $870.96 |
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 $588.84 Median $1,023.29 Typical High $1,479.11 | Professional | None | $588.84 | $1,023.29 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $199.53 Typical High $251.19 | Professional | 80 · Assistant surgeon | $134.90 | $199.53 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $173.78 Typical High $218.78 | Professional | AS · PA/NP assist | $117.49 | $173.78 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,248.07 Typical High $7,244.36 | Facility | None | $812.83 | $5,248.07 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $2,041.74 | Professional | None | $851.14 | $1,202.26 | $2,041.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $691.83 Median $1,122.02 Typical High $2,137.96 | Professional | None | $691.83 | $1,122.02 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,949.84 | Professional | None | $741.31 | $1,122.02 | $1,949.84 |
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 $354.81 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $660.69 | Professional | 54 · Surgery only | $524.81 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $107.15 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $616.60 |
Where New Hampshire sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 20th of 51
$1,023
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.