How much rates vary
Facilitymedian $6,166 · 10th to 90th $2,692 to $11,220Professionalmedian $3,631 · 10th to 90th $2,570 to $6,607
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 $3,890.45 Typical High $15,848.93 | Facility | None | $2,398.83 | $3,890.45 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,398.83 | $2,691.53 | $2,691.53 |
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 $3,090.30 Median $4,677.35 Typical High $6,606.93 | Professional | None | $3,090.30 | $4,677.35 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,949.84 Median $2,951.21 Typical High $4,168.69 | Professional | 62 · Two surgeons | $1,949.84 | $2,951.21 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $758.58 Typical High $1,071.52 | Professional | 80 · Assistant surgeon | $489.78 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $436.52 Median $660.69 Typical High $933.25 | Professional | AS · PA/NP assist | $436.52 | $660.69 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,079.46 Typical High $8,912.51 | Facility | None | $630.96 | $7,079.46 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,630.78 Typical High $7,413.10 | Professional | None | $2,951.21 | $3,630.78 | $7,413.10 |
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 $2,511.89 Median $3,630.78 Typical High $6,456.54 | Professional | None | $2,511.89 | $3,630.78 | $6,456.54 |
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 $2,691.53 Median $3,388.44 Typical High $6,165.95 | Professional | None | $2,691.53 | $3,388.44 | $6,165.95 |
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 $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,230.27 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $489.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,819.70 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $363.08 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $245.47 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,905.46 | $1,905.46 |
Where New Hampshire sits
The same service costs 4.0 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.
Physician feeFacility fee
AK $19,772TX $4,915
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.