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 $741.31 Median $758.58 Typical High $912.01 | Professional | None | $741.31 | $758.58 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $10,000.00 Typical High $18,197.01 | Facility | None | $8,912.51 | $10,000.00 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,412.54 Typical High $1,819.70 | Professional | None | $741.31 | $1,412.54 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $812.83 Typical High $1,096.48 | Professional | 62 · Two surgeons | $467.74 | $812.83 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $208.93 Typical High $281.84 | Professional | 80 · Assistant surgeon | $117.49 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $181.97 Typical High $245.47 | Professional | AS · PA/NP assist | $104.71 | $181.97 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $5,370.32 Typical High $7,244.36 | Facility | None | $933.25 | $5,370.32 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,412.54 Typical High $1,995.26 | Professional | None | $891.25 | $1,412.54 | $1,995.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $812.83 Median $1,122.02 Typical High $2,089.30 | Professional | None | $812.83 | $1,122.02 | $2,089.30 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $2,089.30 | Professional | None | $794.33 | $1,047.13 | $2,089.30 |
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 $371.54 Median $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $371.54 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $177.83 | Professional | 53 · Discontinued | $147.91 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $575.44 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $575.44 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $114.82 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $89.13 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $537.03 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $537.03 | $630.96 |
Where New Hampshire sits
The same service costs 25.1 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
$1,259
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.