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 $2,290.87 Median $2,290.87 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,290.87 | $2,754.23 |
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 $562.34 Median $562.34 Typical High $575.44 | Professional | None | $562.34 | $562.34 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 62 · Two surgeons | $354.81 | $354.81 | $363.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $89.13 Typical High $91.20 | Professional | 80 · Assistant surgeon | $89.13 | $89.13 | $91.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $77.62 Typical High $79.43 | Professional | AS · PA/NP assist | $77.62 | $77.62 | $79.43 |
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 $645.65 Median $912.01 Typical High $1,445.44 | Professional | None | $645.65 | $912.01 | $1,445.44 |
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 $489.78 Median $660.69 Typical High $1,230.27 | Professional | None | $489.78 | $660.69 | $1,230.27 |
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 $478.63 Median $616.60 Typical High $1,230.27 | Professional | None | $478.63 | $616.60 | $1,230.27 |
Well Sense Setting Facility Modifier None Typical Low $416.87 Median $489.78 Typical High $588.84 | Facility | None | $416.87 | $489.78 | $588.84 |
4 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 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $275.42 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,949.84 |
Where New Hampshire sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 19th of 51
$676
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.