How much rates vary
Facilitymedian $5,012 · 10th to 90th $2,344 to $9,120Professionalmedian $1,175 · 10th to 90th $832 to $2,138
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 $5,370.32 Typical High $22,387.21 | Facility | None | $2,398.83 | $5,370.32 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $933.25 | Professional | None | $794.33 | $933.25 | $933.25 |
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 $954.99 Median $1,479.11 Typical High $2,137.96 | Professional | None | $954.99 | $1,479.11 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $2,187.76 Typical High $3,235.94 | Professional | 50 · Both sides | $1,445.44 | $2,187.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $933.25 Typical High $1,348.96 | Professional | 62 · Two surgeons | $602.56 | $933.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $234.42 Typical High $346.74 | Professional | 80 · Assistant surgeon | $154.88 | $234.42 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $204.17 Typical High $302.00 | Professional | AS · PA/NP assist | $134.90 | $204.17 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $5,248.07 Typical High $7,244.36 | Facility | None | $1,288.25 | $5,248.07 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $2,454.71 | Professional | None | $954.99 | $1,174.90 | $2,454.71 |
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 $776.25 Median $1,174.90 Typical High $2,290.87 | Professional | None | $776.25 | $1,174.90 | $2,290.87 |
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 $851.14 Median $1,096.48 Typical High $1,995.26 | Professional | None | $851.14 | $1,096.48 | $1,995.26 |
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 $407.38 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $407.38 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $162.18 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $602.56 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $81.28 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $562.34 | $645.65 | $645.65 |
Where New Hampshire sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $10,315KY $2,095
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.