How much rates vary
Facilitymedian $8,913 · 10th to 90th $2,884 to $26,915Professionalmedian $5,754 · 10th to 90th $4,074 to $10,471
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 $4,073.80 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,073.80 | $4,786.30 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $10,000.00 Typical High $18,197.01 | Facility | None | $8,912.51 | $10,000.00 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,466.84 Median $7,244.36 Typical High $10,471.29 | Professional | None | $4,466.84 | $7,244.36 | $10,471.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $7,079.46 Median $10,715.19 Typical High $15,848.93 | Professional | 50 · Both sides | $7,079.46 | $10,715.19 | $15,848.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,951.21 Median $4,570.88 Typical High $6,606.93 | Professional | 62 · Two surgeons | $2,951.21 | $4,570.88 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $758.58 Median $1,148.15 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $758.58 | $1,148.15 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $660.69 Median $1,000.00 Typical High $1,479.11 | Professional | AS · PA/NP assist | $660.69 | $1,000.00 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $26,302.68 Typical High $33,113.11 | Facility | None | $630.96 | $26,302.68 | $33,113.11 |
Cigna Setting Professional Modifier None Typical Low $4,677.35 Median $5,754.40 Typical High $11,748.98 | Professional | None | $4,677.35 | $5,754.40 | $11,748.98 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $10,964.78 | Facility | None | $2,884.03 | $4,168.69 | $10,964.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3,801.89 Median $5,754.40 Typical High $10,000.00 | Professional | None | $3,801.89 | $5,754.40 | $10,000.00 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $5,754.40 Typical High $10,964.78 | Facility | None | $2,884.03 | $5,754.40 | $10,964.78 |
United Setting Professional Modifier None Typical Low $4,786.30 Median $5,888.44 Typical High $10,000.00 | Professional | None | $4,786.30 | $5,888.44 | $10,000.00 |
6 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 $2,041.74 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,041.74 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $812.83 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,090.30 Median $3,630.78 Typical High $3,630.78 | Professional | 54 · Surgery only | $3,090.30 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $616.60 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $407.38 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,884.03 Median $3,388.44 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,884.03 | $3,388.44 | $3,388.44 |
Where New Hampshire sits
The same service costs 20.4 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· 19th of 51
$5,754
AK $15,849TX $776
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.