How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,692 to $10,471Professionalmedian $2,188 · 10th to 90th $1,549 to $3,981
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 $1,479.11 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,479.11 | $1,698.24 | $1,698.24 |
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 $2,754.23 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,754.23 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,691.53 Median $4,073.80 Typical High $5,888.44 | Professional | 50 · Both sides | $2,691.53 | $4,073.80 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,737.80 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,122.02 | $1,737.80 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $436.52 Typical High $630.96 | Professional | 80 · Assistant surgeon | $288.40 | $436.52 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $380.19 Typical High $549.54 | Professional | AS · PA/NP assist | $251.19 | $380.19 | $549.54 |
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 $1,778.28 Median $2,187.76 Typical High $4,365.16 | Professional | None | $1,778.28 | $2,187.76 | $4,365.16 |
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 $1,445.44 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,445.44 | $2,137.96 | $3,715.35 |
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 $1,659.59 Median $2,041.74 Typical High $3,715.35 | Professional | None | $1,659.59 | $2,041.74 | $3,715.35 |
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 $758.58 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,202.26 | $1,202.26 |
Where New Hampshire sits
The same service costs 8.7 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· 18th of 51
$2,291
AK $5,888TX $676
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.