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 $5,370.32 Typical High $22,387.21 | Facility | None | $2,398.83 | $5,370.32 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $912.01 | Professional | None | $741.31 | $776.25 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $18,197.01 Typical High $28,183.83 | Facility | None | $8,912.51 | $18,197.01 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,412.54 Typical High $1,819.70 | Professional | None | $758.58 | $1,412.54 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $478.63 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $208.93 Typical High $281.84 | Professional | 80 · Assistant surgeon | $120.23 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $186.21 Typical High $251.19 | Professional | AS · PA/NP assist | $104.71 | $186.21 | $251.19 |
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 $891.25 Median $1,445.44 Typical High $1,995.26 | Professional | None | $891.25 | $1,445.44 | $1,995.26 |
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 $812.83 Median $1,096.48 Typical High $2,137.96 | Professional | None | $812.83 | $1,096.48 | $2,137.96 |
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 $812.83 Median $1,071.52 Typical High $2,137.96 | Professional | None | $812.83 | $1,071.52 | $2,137.96 |
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 $389.05 Typical High $457.09 | Professional | 52 · Reduced service | $371.54 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $562.34 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $91.20 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $630.96 |
Where New Hampshire sits
The same service costs 5.9 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· 13th 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.