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 $295.12 Median $1,621.81 Typical High $1,621.81 | Professional | None | $295.12 | $1,621.81 | $1,621.81 |
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 $251.19 Median $251.19 Typical High $257.04 | Professional | None | $251.19 | $251.19 | $257.04 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $158.49 Median $158.49 Typical High $162.18 | Professional | 62 · Two surgeons | $158.49 | $158.49 | $162.18 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $40.74 Typical High $41.69 | Professional | 80 · Assistant surgeon | $40.74 | $40.74 | $41.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | AS · PA/NP assist | $35.48 | $35.48 | $35.48 |
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 $331.13 Median $489.78 Typical High $758.58 | Professional | None | $331.13 | $489.78 | $758.58 |
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 $223.87 Median $302.00 Typical High $562.34 | Professional | None | $223.87 | $302.00 | $562.34 |
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 $213.80 Median $281.84 Typical High $562.34 | Professional | None | $213.80 | $281.84 | $562.34 |
Well Sense Setting Facility Modifier None Typical Low $190.55 Median $223.87 Typical High $269.15 | Facility | None | $190.55 | $223.87 | $269.15 |
3 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 $223.87 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $223.87 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $44.67 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $29.51 | $162.18 | $162.18 |
Where New Hampshire sits
The same service costs 8.1 times more in New York than in Missouri. 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· 29th of 51
$309
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.