How much rates vary
Facilitymedian $7,079 · 10th to 90th $2,692 to $33,884Professionalmedian $1,698 · 10th to 90th $1,202 to $3,090
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 $4,466.84 Typical High $20,892.96 | Facility | None | $2,398.83 | $4,466.84 | $20,892.96 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,318.26 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $16,218.10 Median $33,884.42 Typical High $52,480.75 | Facility | None | $16,218.10 | $33,884.42 | $52,480.75 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,412.54 | $2,137.96 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $3,235.94 Typical High $4,570.88 | Professional | 50 · Both sides | $2,089.30 | $3,235.94 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,348.96 Typical High $1,949.84 | Professional | 62 · Two surgeons | $891.25 | $1,348.96 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $338.84 Typical High $489.78 | Professional | 80 · Assistant surgeon | $223.87 | $338.84 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $302.00 Typical High $426.58 | Professional | AS · PA/NP assist | $194.98 | $302.00 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $16,595.87 Typical High $20,892.96 | Facility | None | $630.96 | $16,595.87 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,412.54 | $1,698.24 | $3,388.44 |
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 $1,148.15 Median $1,698.24 Typical High $3,311.31 | Professional | None | $1,148.15 | $1,698.24 | $3,311.31 |
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 $1,258.93 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,548.82 | $2,884.03 |
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 $588.84 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $870.96 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $812.83 | $912.01 | $912.01 |
Where New Hampshire sits
The same service costs 10.4 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 $29,118KY $2,808
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.