How much rates vary
Facilitymedian $3,162 · 10th to 90th $2,188 to $6,310Professionalmedian $2,455 · 10th to 90th $1,778 to $4,467
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 $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,548.82 | $1,819.70 | $1,819.70 |
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 $2,089.30 Median $3,162.28 Typical High $4,466.84 | Professional | None | $2,089.30 | $3,162.28 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $4,786.30 Typical High $6,606.93 | Professional | 50 · Both sides | $3,090.30 | $4,786.30 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $512.86 Typical High $707.95 | Professional | 80 · Assistant surgeon | $331.13 | $512.86 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $446.68 Typical High $616.60 | Professional | AS · PA/NP assist | $288.40 | $446.68 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,884.03 Typical High $3,981.07 | Facility | None | $575.44 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $5,011.87 | Professional | None | $1,995.26 | $2,454.71 | $5,011.87 |
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 $1,698.24 Median $2,511.89 Typical High $4,897.79 | Professional | None | $1,698.24 | $2,511.89 | $4,897.79 |
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 $1,862.09 Median $2,238.72 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,238.72 | $4,073.80 |
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 $776.25 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $776.25 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,174.90 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $234.42 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,258.93 | $1,258.93 |
Where New Hampshire sits
The same service costs 7.8 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
$2,512
AK $6,761TX $871
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.