How much rates vary
Facilitymedian $5,129 · 10th to 90th $2,692 to $8,913Professionalmedian $3,020 · 10th to 90th $1,862 to $5,495
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 $3,890.45 Typical High $15,848.93 | Facility | None | $2,398.83 | $3,890.45 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,137.96 | $2,187.76 | $2,187.76 |
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 $2,187.76 Median $3,801.89 Typical High $5,495.41 | Professional | None | $2,187.76 | $3,801.89 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $5,623.41 Typical High $8,317.64 | Professional | 50 · Both sides | $3,715.35 | $5,623.41 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,398.83 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,548.82 | $2,398.83 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $602.56 Typical High $891.25 | Professional | 80 · Assistant surgeon | $398.11 | $602.56 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $524.81 Typical High $776.25 | Professional | AS · PA/NP assist | $346.74 | $524.81 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,079.46 Typical High $8,912.51 | Facility | None | $630.96 | $7,079.46 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $6,165.95 | Professional | None | $2,137.96 | $3,019.95 | $6,165.95 |
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 $1,905.46 Median $2,884.03 Typical High $5,248.07 | Professional | None | $1,905.46 | $2,884.03 | $5,248.07 |
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 $1,230.27 Median $2,818.38 Typical High $5,248.07 | Professional | None | $1,230.27 | $2,818.38 | $5,248.07 |
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 $1,071.52 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $1,071.52 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $426.58 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,584.89 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $316.23 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,548.82 | $1,548.82 |
Where New Hampshire sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.