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 $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $562.34 Typical High $645.65 | Professional | None | $549.54 | $562.34 | $645.65 |
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 $660.69 Median $1,096.48 Typical High $1,348.96 | Professional | None | $660.69 | $1,096.48 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $616.60 Typical High $831.76 | Professional | 62 · Two surgeons | $354.81 | $616.60 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $154.88 Typical High $208.93 | Professional | 80 · Assistant surgeon | $89.13 | $154.88 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $138.04 Typical High $181.97 | Professional | AS · PA/NP assist | $79.43 | $138.04 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $1,659.59 | Facility | None | $537.03 | $1,258.93 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,479.11 | Professional | None | $660.69 | $1,047.13 | $1,479.11 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,584.89 | Professional | None | $602.56 | $831.76 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,479.11 | Professional | None | $588.84 | $776.25 | $1,479.11 |
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 $275.42 Median $281.84 Typical High $309.03 | Professional | 52 · Reduced service | $275.42 | $281.84 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $112.20 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $426.58 Typical High $467.74 | Professional | 54 · Surgery only | $416.87 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $85.11 Typical High $93.33 | Professional | 55 · Aftercare only | $83.18 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $56.23 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $398.11 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $389.05 | $398.11 | $436.52 |
Where New Hampshire sits
The same service costs 5.5 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· 13th of 51
$955
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.