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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $602.56 | Professional | None | $524.81 | $549.54 | $602.56 |
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 $562.34 Median $912.01 Typical High $1,148.15 | Professional | None | $562.34 | $912.01 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $77.62 Median $134.90 Typical High $177.83 | Professional | 80 · Assistant surgeon | $77.62 | $134.90 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $67.61 Median $117.49 Typical High $154.88 | Professional | AS · PA/NP assist | $67.61 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $5,248.07 Typical High $7,244.36 | Facility | None | $660.69 | $5,248.07 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,318.26 | Professional | None | $562.34 | $691.83 | $1,318.26 |
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 $489.78 Median $724.44 Typical High $1,380.38 | Professional | None | $489.78 | $724.44 | $1,380.38 |
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 $524.81 Median $707.95 Typical High $1,380.38 | Professional | None | $524.81 | $707.95 | $1,380.38 |
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 $263.03 Median $275.42 Typical High $295.12 | Professional | 52 · Reduced service | $263.03 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $104.71 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $416.87 Typical High $446.68 | Professional | 54 · Surgery only | $389.05 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $77.62 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $52.48 | $54.95 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $389.05 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $363.08 | $389.05 | $416.87 |
Where New Hampshire sits
The same service costs 6.3 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· 16th of 51
$759
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.