How much rates vary
Facilitymedian $5,012 · 10th to 90th $2,344 to $9,333Professionalmedian $1,479 · 10th to 90th $1,023 to $2,692
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 $1,023.29 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,023.29 | $1,148.15 | $1,148.15 |
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 $1,258.93 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,862.09 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,754.23 Typical High $4,073.80 | Professional | 50 · Both sides | $1,819.70 | $2,754.23 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,174.90 Typical High $1,698.24 | Professional | 62 · Two surgeons | $758.58 | $1,174.90 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $295.12 Typical High $436.52 | Professional | 80 · Assistant surgeon | $194.98 | $295.12 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $257.04 Typical High $380.19 | Professional | AS · PA/NP assist | $169.82 | $257.04 | $380.19 |
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 $1,202.26 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,479.11 | $3,019.95 |
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 $977.24 Median $1,479.11 Typical High $2,884.03 | Professional | None | $977.24 | $1,479.11 | $2,884.03 |
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 $1,096.48 Median $1,412.54 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,412.54 | $2,570.40 |
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 $512.86 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $512.86 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $204.17 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $794.33 | $794.33 |
Where New Hampshire sits
The same service costs 18.2 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· 18th of 51
$1,549
AK $4,074TX $224
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.