How much rates vary
Facilitymedian $6,457 · 10th to 90th $2,692 to $19,953Professionalmedian $1,349 · 10th to 90th $955 to $2,455
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 $912.01 Median $1,023.29 Typical High $1,122.02 | Professional | None | $912.01 | $1,023.29 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $10,471.29 Typical High $19,952.62 | Facility | None | $9,332.54 | $10,471.29 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,318.26 | $1,737.80 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,698.24 Median $2,570.40 Typical High $3,630.78 | Professional | 50 · Both sides | $1,698.24 | $2,570.40 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $1,096.48 Typical High $1,548.82 | Professional | 62 · Two surgeons | $707.95 | $1,096.48 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $275.42 Typical High $389.05 | Professional | 80 · Assistant surgeon | $181.97 | $275.42 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $239.88 Typical High $338.84 | Professional | AS · PA/NP assist | $158.49 | $239.88 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $15,488.17 Typical High $21,379.62 | Facility | None | $812.83 | $15,488.17 | $21,379.62 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $2,754.23 | Professional | None | $1,122.02 | $1,348.96 | $2,754.23 |
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 $912.01 Median $1,348.96 Typical High $2,691.53 | Professional | None | $912.01 | $1,348.96 | $2,691.53 |
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 $1,023.29 Median $1,230.27 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,230.27 | $2,238.72 |
Well Sense Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
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 $457.09 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $691.83 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $645.65 | $724.44 | $724.44 |
Where New Hampshire sits
The same service costs 6.8 times more in Alaska than in Montana. 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 $19,480MT $2,858
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.