How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,344 to $10,233Professionalmedian $1,738 · 10th to 90th $1,259 to $3,236
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 $1,230.27 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,230.27 | $1,412.54 | $1,412.54 |
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 $1,445.44 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,445.44 | $2,187.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $3,311.31 Typical High $4,786.30 | Professional | 50 · Both sides | $2,187.76 | $3,311.31 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,380.38 Typical High $2,041.74 | Professional | 62 · Two surgeons | $912.01 | $1,380.38 | $2,041.74 |
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 $204.17 Median $309.03 Typical High $446.68 | Professional | AS · PA/NP assist | $204.17 | $309.03 | $446.68 |
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 $1,445.44 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 $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
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 $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $3,019.95 | Professional | None | $1,479.11 | $1,778.28 | $3,019.95 |
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 $616.60 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $977.24 | $977.24 |
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· 19th of 51
$1,862
AK $4,786TX $550
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.