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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $851.14 | Professional | None | $630.96 | $851.14 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,445.44 | Professional | None | $741.31 | $1,023.29 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,548.82 Typical High $2,187.76 | Professional | 50 · Both sides | $1,096.48 | $1,548.82 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $645.65 Typical High $912.01 | Professional | 62 · Two surgeons | $467.74 | $645.65 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $165.96 Typical High $234.42 | Professional | 80 · Assistant surgeon | $125.89 | $165.96 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $102.33 | $144.54 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $6,760.83 | Facility | None | $1,659.59 | $1,698.24 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,819.70 | Professional | None | $758.58 | $954.99 | $1,819.70 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $8,912.51 | Facility | None | $2,187.76 | $2,691.53 | $8,912.51 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $1,047.13 | Professional | None | $426.58 | $588.84 | $1,047.13 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $8,912.51 | Facility | None | $2,187.76 | $3,162.28 | $8,912.51 |
United Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $1,047.13 | Professional | None | $398.11 | $537.03 | $1,047.13 |
Well Sense Setting Facility Modifier None Typical Low $363.08 Median $426.58 Typical High $512.86 | Facility | None | $363.08 | $426.58 | $512.86 |
5 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 $309.03 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $309.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $467.74 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $93.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $63.10 | $85.11 | $85.11 |
Where New Hampshire sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 5th of 51
$933
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.