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 $575.44 Median $630.96 Typical High $758.58 | Professional | None | $575.44 | $630.96 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $7,762.47 Typical High $13,182.57 | Facility | None | $3,801.89 | $7,762.47 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,584.89 | Professional | None | $776.25 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $741.31 Typical High $1,000.00 | Professional | 62 · Two surgeons | $416.87 | $741.31 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $186.21 Typical High $251.19 | Professional | 80 · Assistant surgeon | $107.15 | $186.21 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $165.96 Typical High $218.78 | Professional | AS · PA/NP assist | $93.33 | $165.96 | $218.78 |
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 $758.58 Median $1,258.93 Typical High $1,737.80 | Professional | None | $758.58 | $1,258.93 | $1,737.80 |
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 $724.44 Median $954.99 Typical High $1,819.70 | Professional | None | $724.44 | $954.99 | $1,819.70 |
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 $676.08 Median $912.01 Typical High $1,621.81 | Professional | None | $676.08 | $912.01 | $1,621.81 |
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 $288.40 Median $316.23 Typical High $338.84 | Professional | 52 · Reduced service | $288.40 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $125.89 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $467.74 Typical High $512.86 | Professional | 54 · Surgery only | $436.52 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $93.33 Typical High $102.33 | Professional | 55 · Aftercare only | $87.10 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $436.52 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $436.52 | $478.63 |
Where New Hampshire sits
The same service costs 5.4 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· 11th of 51
$1,148
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.