How much rates vary
Facilitymedian $3,162 · 10th to 90th $2,188 to $6,310Professionalmedian $1,445 · 10th to 90th $1,023 to $2,570
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 $870.96 Median $1,023.29 Typical High $1,023.29 | Professional | None | $870.96 | $1,023.29 | $1,023.29 |
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 $1,230.27 Median $1,862.09 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,174.90 Typical High $1,584.89 | Professional | 62 · Two surgeons | $776.25 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $302.00 Typical High $398.11 | Professional | 80 · Assistant surgeon | $194.98 | $302.00 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $263.03 Typical High $354.81 | Professional | AS · PA/NP assist | $169.82 | $263.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,884.03 Typical High $3,981.07 | Facility | None | $660.69 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,818.38 | Professional | None | $1,202.26 | $1,380.38 | $2,818.38 |
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 $1,000.00 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,000.00 | $1,445.44 | $2,818.38 |
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 $1,122.02 Median $1,318.26 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,318.26 | $2,238.72 |
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 $436.52 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $173.78 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $660.69 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $616.60 | $707.95 | $707.95 |
Where New Hampshire sits
The same service costs 3.1 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 $8,167HI $2,648
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.