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 $724.44 Median $1,047.13 Typical High $1,047.13 | Professional | None | $724.44 | $1,047.13 | $1,047.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,862.09 | Professional | None | $776.25 | $1,202.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $758.58 Typical High $1,174.90 | Professional | 62 · Two surgeons | $501.19 | $758.58 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $194.98 Typical High $302.00 | Professional | 80 · Assistant surgeon | $128.82 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $169.82 Typical High $263.03 | Professional | AS · PA/NP assist | $112.20 | $169.82 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $549.54 Typical High $2,691.53 | Facility | None | $489.78 | $549.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $2,041.74 | Professional | None | $831.76 | $1,071.52 | $2,041.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,659.59 | Professional | None | $645.65 | $977.24 | $1,659.59 |
United Setting Facility Modifier None Typical Low $323.59 Median $524.81 Typical High $2,344.23 | Facility | None | $323.59 | $524.81 | $2,344.23 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,659.59 | Professional | None | $741.31 | $1,023.29 | $1,659.59 |
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 $363.08 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $363.08 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $144.54 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $537.03 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $107.15 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $72.44 | $104.71 | $104.71 |
Where New Hampshire sits
The same service costs 4.7 times more in Alaska than in Utah. 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· 14th of 51
$1,047
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.