How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,344 to $9,120Professionalmedian $2,042 · 10th to 90th $1,413 to $3,715
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 $1,380.38 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,380.38 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $5,623.41 Typical High $9,332.54 | Facility | None | $5,011.87 | $5,623.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,570.40 Typical High $3,715.35 | Professional | None | $1,905.46 | $2,570.40 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,621.81 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,071.52 | $1,621.81 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $416.87 Typical High $588.84 | Professional | 80 · Assistant surgeon | $269.15 | $416.87 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $363.08 Typical High $512.86 | Professional | AS · PA/NP assist | $234.42 | $363.08 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $5,754.40 Typical High $7,244.36 | Facility | None | $630.96 | $5,754.40 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $4,073.80 | Professional | None | $1,698.24 | $2,041.74 | $4,073.80 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,380.38 Median $2,041.74 Typical High $3,981.07 | Professional | None | $1,380.38 | $2,041.74 | $3,981.07 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,445.44 | $1,905.46 | $3,388.44 |
Well Sense Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $691.83 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $691.83 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $208.93 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,096.48 |
Where New Hampshire sits
The same service costs 17.0 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· 14th of 51
$2,188
AK $5,495TX $324
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.