How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,692 to $10,471Professionalmedian $1,738 · 10th to 90th $1,230 to $3,162
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 $1,202.26 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,202.26 | $1,380.38 | $1,380.38 |
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 $1,659.59 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,659.59 | $2,187.76 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $3,311.31 Typical High $4,786.30 | Professional | 50 · Both sides | $2,137.96 | $3,311.31 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,380.38 Typical High $1,995.26 | Professional | 62 · Two surgeons | $912.01 | $1,380.38 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $354.81 Typical High $512.86 | Professional | 80 · Assistant surgeon | $229.09 | $354.81 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $309.03 Typical High $446.68 | Professional | AS · PA/NP assist | $199.53 | $309.03 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $9,120.11 Typical High $11,481.54 | Facility | None | $630.96 | $9,120.11 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $3,548.13 | Professional | None | $1,445.44 | $1,737.80 | $3,548.13 |
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 $1,174.90 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,174.90 | $1,737.80 | $3,019.95 |
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 $1,318.26 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,659.59 | $2,951.21 |
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 $602.56 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $239.88 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $912.01 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $851.14 | $954.99 | $954.99 |
Where New Hampshire sits
The same service costs 5.5 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.
Physician feeFacility fee
AK $14,559TX $2,668
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.