How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,862 to $11,220Professionalmedian $3,162 · 10th to 90th $2,188 to $5,495
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 $2,089.30 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,089.30 | $2,511.89 | $2,511.89 |
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 $2,344.23 Median $3,801.89 Typical High $5,495.41 | Professional | None | $2,344.23 | $3,801.89 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $5,754.40 Typical High $8,317.64 | Professional | 50 · Both sides | $3,715.35 | $5,754.40 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,398.83 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,584.89 | $2,398.83 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $602.56 Typical High $891.25 | Professional | 80 · Assistant surgeon | $398.11 | $602.56 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $537.03 Typical High $776.25 | Professional | AS · PA/NP assist | $346.74 | $537.03 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $2,089.30 Typical High $2,691.53 | Facility | None | $630.96 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $3,019.95 Typical High $6,165.95 | Professional | None | $2,454.71 | $3,019.95 | $6,165.95 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $5,128.61 | Professional | None | $2,041.74 | $3,162.28 | $5,128.61 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $2,630.27 Median $3,388.44 Typical High $5,011.87 | Professional | None | $2,630.27 | $3,388.44 | $5,011.87 |
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 $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,047.13 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,584.89 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,778.28 | $1,778.28 |
Where New Hampshire sits
The same service costs 19.5 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· 17th of 51
$3,162
AK $8,318TX $427
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.