How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,692 to $10,471Professionalmedian $2,512 · 10th to 90th $1,820 to $4,571
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 $1,778.28 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,778.28 | $1,995.26 | $1,995.26 |
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 $2,454.71 Median $3,162.28 Typical High $4,570.88 | Professional | None | $2,454.71 | $3,162.28 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,090.30 Median $4,786.30 Typical High $6,918.31 | Professional | 50 · Both sides | $3,090.30 | $4,786.30 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,995.26 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,318.26 | $1,995.26 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $512.86 Typical High $741.31 | Professional | 80 · Assistant surgeon | $331.13 | $512.86 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $446.68 Typical High $645.65 | Professional | AS · PA/NP assist | $288.40 | $446.68 | $645.65 |
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 $2,089.30 Median $2,511.89 Typical High $5,128.61 | Professional | None | $2,089.30 | $2,511.89 | $5,128.61 |
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 $1,698.24 Median $2,511.89 Typical High $4,365.16 | Professional | None | $1,698.24 | $2,511.89 | $4,365.16 |
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 $1,949.84 Median $2,398.83 Typical High $4,265.80 | Professional | None | $1,949.84 | $2,398.83 | $4,265.80 |
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 $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $891.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $354.81 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,318.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,380.38 | $1,380.38 |
Where New Hampshire sits
The same service costs 9.3 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
$2,692
AK $6,918TX $741
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.