How much rates vary
Facilitymedian $3,631 · 10th to 90th $2,188 to $11,220Professionalmedian $1,349 · 10th to 90th $933 to $2,399
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 $3,388.44 Typical High $14,791.08 | Facility | None | $2,398.83 | $3,388.44 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | None | $851.14 | $954.99 | $954.99 |
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 $1,000.00 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,778.28 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,096.48 Typical High $1,479.11 | Professional | 62 · Two surgeons | $724.44 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $281.84 Typical High $380.19 | Professional | 80 · Assistant surgeon | $186.21 | $281.84 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $245.47 Typical High $331.13 | Professional | AS · PA/NP assist | $162.18 | $245.47 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $8,128.31 Typical High $11,220.18 | Facility | None | $812.83 | $8,128.31 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,318.26 | $2,691.53 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $933.25 Median $1,348.96 Typical High $2,630.27 | Professional | None | $933.25 | $1,348.96 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,089.30 | Professional | None | $1,071.52 | $1,258.93 | $2,089.30 |
Well Sense Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $426.58 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $426.58 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $169.82 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $630.96 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $85.11 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $588.84 | $676.08 | $676.08 |
Where New Hampshire sits
The same service costs 4.5 times more in Alaska than in Montana. 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 $12,963MT $2,892
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.