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 $630.96 Median $645.65 Typical High $724.44 | Professional | None | $630.96 | $645.65 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,715.19 Median $12,022.64 Typical High $22,908.68 | Facility | None | $10,715.19 | $12,022.64 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,380.38 Typical High $1,778.28 | Professional | None | $741.31 | $1,380.38 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $204.17 Typical High $275.42 | Professional | 80 · Assistant surgeon | $114.82 | $204.17 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $177.83 Typical High $239.88 | Professional | AS · PA/NP assist | $100.00 | $177.83 | $239.88 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $776.25 Median $1,023.29 Typical High $1,905.46 | Professional | None | $776.25 | $1,023.29 | $1,905.46 |
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 $707.95 Median $954.99 Typical High $1,905.46 | Professional | None | $707.95 | $954.99 | $1,905.46 |
4 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 $467.74 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $95.50 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $446.68 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $446.68 | $457.09 |
Where New Hampshire sits
The same service costs 3.8 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· 7th of 51
$1,230
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.