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 $3,981.07 Median $3,981.07 Typical High $4,897.79 | Professional | None | $3,981.07 | $3,981.07 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,570.88 Median $7,585.78 Typical High $10,000.00 | Professional | None | $4,570.88 | $7,585.78 | $10,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,691.53 Median $4,570.88 Typical High $6,165.95 | Professional | 62 · Two surgeons | $2,691.53 | $4,570.88 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $691.83 Median $1,148.15 Typical High $1,548.82 | Professional | 80 · Assistant surgeon | $691.83 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $602.56 Median $1,000.00 Typical High $1,348.96 | Professional | AS · PA/NP assist | $602.56 | $1,000.00 | $1,348.96 |
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 $4,677.35 Median $7,762.47 Typical High $11,220.18 | Professional | None | $4,677.35 | $7,762.47 | $11,220.18 |
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 $4,365.16 Median $5,888.44 Typical High $11,748.98 | Professional | None | $4,365.16 | $5,888.44 | $11,748.98 |
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 $4,466.84 Median $5,888.44 Typical High $11,748.98 | Professional | None | $4,466.84 | $5,888.44 | $11,748.98 |
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 $1,995.26 Median $1,995.26 Typical High $2,454.71 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $2,454.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $1,000.00 | Professional | 53 · Discontinued | $794.33 | $794.33 | $1,000.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,019.95 Median $3,019.95 Typical High $3,715.35 | Professional | 54 · Surgery only | $3,019.95 | $3,019.95 | $3,715.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $741.31 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $741.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $489.78 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,818.38 Median $2,818.38 Typical High $3,467.37 | Professional | 78 · Unplanned return to OR | $2,818.38 | $2,818.38 | $3,467.37 |
Where New Hampshire sits
The same service costs 20.9 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· 12th of 51
$6,918
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.