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 $630.96 Median $676.08 Typical High $741.31 | Professional | None | $630.96 | $676.08 | $741.31 |
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 $691.83 Median $1,148.15 Typical High $1,380.38 | Professional | None | $691.83 | $1,148.15 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $645.65 Typical High $851.14 | Professional | 62 · Two surgeons | $389.05 | $645.65 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $165.96 Typical High $218.78 | Professional | 80 · Assistant surgeon | $100.00 | $165.96 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $144.54 Typical High $190.55 | Professional | AS · PA/NP assist | $87.10 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,818.38 Typical High $3,548.13 | Facility | None | $812.83 | $2,818.38 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,584.89 | Professional | None | $691.83 | $851.14 | $1,584.89 |
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 $588.84 Median $891.25 Typical High $1,737.80 | Professional | None | $588.84 | $891.25 | $1,737.80 |
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 $645.65 Median $870.96 Typical High $1,778.28 | Professional | None | $645.65 | $870.96 | $1,778.28 |
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 $316.23 Median $338.84 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $125.89 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $501.19 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $501.19 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 55 · Aftercare only | $95.50 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $72.44 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $467.74 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $467.74 | $501.19 |
Where New Hampshire sits
The same service costs 6.5 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
$933
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.