How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $229.09 Median $245.47 Typical High $288.40 | Professional | None | $229.09 | $245.47 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $10,000.00 Typical High $16,982.44 | Facility | None | $3,890.45 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $426.58 Typical High $562.34 | Professional | None | $263.03 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $154.88 Median $257.04 Typical High $338.84 | Professional | 62 · Two surgeons | $154.88 | $257.04 | $338.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $64.57 Typical High $87.10 | Professional | 80 · Assistant surgeon | $39.81 | $64.57 | $87.10 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $57.54 Typical High $75.86 | Professional | AS · PA/NP assist | $34.67 | $57.54 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $2,691.53 | Facility | None | $489.78 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $660.69 | Professional | None | $302.00 | $436.52 | $660.69 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $851.14 Typical High $2,884.03 | Facility | None | $776.25 | $851.14 | $2,884.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $660.69 | Professional | None | $239.88 | $338.84 | $660.69 |
United Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $2,884.03 | Facility | None | $776.25 | $933.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $676.08 | Professional | None | $257.04 | $338.84 | $676.08 |
5 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 $114.82 Median $123.03 Typical High $138.04 | Professional | 52 · Reduced service | $114.82 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $48.98 Typical High $56.23 | Professional | 53 · Discontinued | $45.71 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $186.21 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $37.15 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $27.54 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $27.54 |
Where New Hampshire sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$389
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.