How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,698 to $6,166Professionalmedian $661 · 10th to 90th $457 to $1,175
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 $1,819.70 Median $2,398.83 Typical High $9,772.37 | Facility | None | $1,819.70 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $478.63 | Professional | None | $426.58 | $478.63 | $478.63 |
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 $562.34 Median $851.14 Typical High $1,174.90 | Professional | None | $562.34 | $851.14 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,288.25 Typical High $1,737.80 | Professional | 50 · Both sides | $831.76 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $537.03 Typical High $741.31 | Professional | 62 · Two surgeons | $346.74 | $537.03 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $134.90 Typical High $186.21 | Professional | 80 · Assistant surgeon | $89.13 | $134.90 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $120.23 Typical High $162.18 | Professional | AS · PA/NP assist | $77.62 | $120.23 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $2,884.03 Typical High $3,981.07 | Facility | None | $537.03 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,288.25 | Professional | None | $562.34 | $645.65 | $1,288.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $1,288.25 | Professional | None | $446.68 | $660.69 | $1,288.25 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $1,047.13 | Professional | None | $467.74 | $575.44 | $1,047.13 |
Well Sense Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $213.80 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $213.80 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $85.11 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $323.59 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $64.57 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $42.66 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $302.00 | $331.13 | $331.13 |
Where New Hampshire sits
The same service costs 8.3 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· 16th of 51
$692
AK $1,738TX $209
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.