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 $588.84 Median $812.83 Typical High $812.83 | Professional | None | $588.84 | $812.83 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $1,380.38 | Professional | None | $691.83 | $977.24 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,479.11 Typical High $2,089.30 | Professional | 50 · Both sides | $1,047.13 | $1,479.11 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $616.60 Typical High $870.96 | Professional | 62 · Two surgeons | $436.52 | $616.60 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $154.88 Typical High $218.78 | Professional | 80 · Assistant surgeon | $112.20 | $154.88 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $138.04 Typical High $194.98 | Professional | AS · PA/NP assist | $97.72 | $138.04 | $194.98 |
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 $724.44 Median $912.01 Typical High $1,737.80 | Professional | None | $724.44 | $912.01 | $1,737.80 |
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 $389.05 Median $524.81 Typical High $954.99 | Professional | None | $389.05 | $524.81 | $954.99 |
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 $371.54 Median $478.63 Typical High $891.25 | Professional | None | $371.54 | $478.63 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $331.13 Median $389.05 Typical High $467.74 | Facility | None | $331.13 | $389.05 | $467.74 |
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 $295.12 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $295.12 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $117.49 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $446.68 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $89.13 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $58.88 | $81.28 | $81.28 |
Where New Hampshire sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 6th of 51
$891
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.