How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,692 to $13,183Professionalmedian $2,570 · 10th to 90th $1,778 to $4,467
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 $4,466.84 Typical High $20,892.96 | Facility | None | $2,398.83 | $4,466.84 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,659.59 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $3,388.44 Typical High $4,570.88 | Professional | None | $2,187.76 | $3,388.44 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $2,137.96 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,380.38 | $2,137.96 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $537.03 Typical High $724.44 | Professional | 80 · Assistant surgeon | $354.81 | $537.03 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $467.74 Typical High $630.96 | Professional | AS · PA/NP assist | $309.03 | $467.74 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $12,882.50 Typical High $16,218.10 | Facility | None | $630.96 | $12,882.50 | $16,218.10 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $5,011.87 | Professional | None | $2,137.96 | $2,454.71 | $5,011.87 |
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 $1,778.28 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,778.28 | $2,511.89 | $4,466.84 |
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 $1,819.70 Median $2,238.72 Typical High $4,168.69 | Professional | None | $1,819.70 | $2,238.72 | $4,168.69 |
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 $831.76 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $338.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,258.93 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,288.25 | $1,288.25 |
Where New Hampshire sits
The same service costs 5.3 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 $17,981KY $3,363
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.