How much rates vary
Facilitymedian $6,457 · 10th to 90th $2,692 to $19,953Professionalmedian $1,288 · 10th to 90th $933 to $2,344
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 $891.25 Median $1,000.00 Typical High $1,862.09 | Professional | None | $891.25 | $1,000.00 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $10,471.29 Typical High $19,952.62 | Facility | None | $9,332.54 | $10,471.29 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,659.59 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,511.89 Typical High $3,548.13 | Professional | 50 · Both sides | $1,621.81 | $2,511.89 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $1,047.13 Typical High $1,479.11 | Professional | 62 · Two surgeons | $676.08 | $1,047.13 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $263.03 Typical High $380.19 | Professional | 80 · Assistant surgeon | $173.78 | $263.03 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $234.42 Typical High $331.13 | Professional | AS · PA/NP assist | $151.36 | $234.42 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $15,488.17 Typical High $21,379.62 | Facility | None | $660.69 | $15,488.17 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,288.25 | $2,630.27 |
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 $891.25 Median $1,318.26 Typical High $2,570.40 | Professional | None | $891.25 | $1,318.26 | $2,570.40 |
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 $1,023.29 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,230.27 | $2,187.76 |
Well Sense Setting Facility Modifier None Typical Low $6,760.83 Median $6,760.83 Typical High $6,760.83 | Facility | None | $6,760.83 | $6,760.83 | $6,760.83 |
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 $446.68 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $676.08 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $134.90 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $630.96 | $707.95 | $707.95 |
Where New Hampshire sits
The same service costs 7.5 times more in Alaska than in Hawaii. 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 $19,036HI $2,542
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.