How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,344 to $10,000Professionalmedian $5,623 · 10th to 90th $3,802 to $10,233
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 $3,311.31 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,311.31 | $3,801.89 | $3,801.89 |
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 $4,677.35 Median $7,079.46 Typical High $10,232.93 | Professional | None | $4,677.35 | $7,079.46 | $10,232.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $6,918.31 Median $10,715.19 Typical High $15,488.17 | Professional | 50 · Both sides | $6,918.31 | $10,715.19 | $15,488.17 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,951.21 Median $4,466.84 Typical High $6,456.54 | Professional | 62 · Two surgeons | $2,951.21 | $4,466.84 | $6,456.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $741.31 Median $1,122.02 Typical High $1,621.81 | Professional | 80 · Assistant surgeon | $741.31 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $645.65 Median $1,000.00 Typical High $1,445.44 | Professional | AS · PA/NP assist | $645.65 | $1,000.00 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $8,912.51 Typical High $11,220.18 | Facility | None | $630.96 | $8,912.51 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $4,570.88 Median $5,623.41 Typical High $11,481.54 | Professional | None | $4,570.88 | $5,623.41 | $11,481.54 |
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 $3,801.89 Median $5,495.41 Typical High $9,549.93 | Professional | None | $3,801.89 | $5,495.41 | $9,549.93 |
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 $4,365.16 Median $5,370.32 Typical High $9,332.54 | Professional | None | $4,365.16 | $5,370.32 | $9,332.54 |
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 $1,659.59 Median $1,905.46 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,659.59 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $660.69 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,884.03 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,511.89 | $2,884.03 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $575.44 Typical High $575.44 | Professional | 55 · Aftercare only | $501.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $380.19 Typical High $380.19 | Professional | 56 · Pre-op care only | $331.13 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,691.53 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,691.53 | $2,691.53 |
Where New Hampshire sits
The same service costs 20.4 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· 13th of 51
$5,623
AK $15,488TX $759
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.