How much rates vary
Facilitymedian $5,495 · 10th to 90th $2,344 to $11,482Professionalmedian $1,995 · 10th to 90th $1,349 to $3,631
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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,348.96 | $1,445.44 | $1,445.44 |
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 $1,513.56 Median $2,511.89 Typical High $3,630.78 | Professional | None | $1,513.56 | $2,511.89 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $3,801.89 Typical High $5,495.41 | Professional | 50 · Both sides | $2,454.71 | $3,801.89 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,584.89 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,047.13 | $1,584.89 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $407.38 Typical High $588.84 | Professional | 80 · Assistant surgeon | $263.03 | $407.38 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $354.81 Typical High $512.86 | Professional | AS · PA/NP assist | $229.09 | $354.81 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $8,709.64 Typical High $12,022.64 | Facility | None | $660.69 | $8,709.64 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,995.26 Typical High $4,073.80 | Professional | None | $1,479.11 | $1,995.26 | $4,073.80 |
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 $1,348.96 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,348.96 | $1,995.26 | $3,890.45 |
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 $933.25 Median $1,862.09 Typical High $3,388.44 | Professional | None | $933.25 | $1,862.09 | $3,388.44 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $676.08 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $676.08 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,023.29 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $204.17 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $954.99 | $1,000.00 | $1,000.00 |
Where New Hampshire sits
The same service costs 8.9 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
$2,089
AK $5,495TX $617
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.