How much rates vary
Facilitymedian $6,457 · 10th to 90th $2,692 to $19,953Professionalmedian $912 · 10th to 90th $661 to $1,660
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 $616.60 Median $724.44 Typical High $724.44 | Professional | None | $616.60 | $724.44 | $724.44 |
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 $776.25 Median $1,202.26 Typical High $1,659.59 | Professional | None | $776.25 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,778.28 Typical High $2,511.89 | Professional | 50 · Both sides | $1,174.90 | $1,778.28 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $758.58 Typical High $1,047.13 | Professional | 62 · Two surgeons | $489.78 | $758.58 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $190.55 Typical High $269.15 | Professional | 80 · Assistant surgeon | $125.89 | $190.55 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $165.96 Typical High $234.42 | Professional | AS · PA/NP assist | $109.65 | $165.96 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $16,595.87 Typical High $22,908.68 | Facility | None | $812.83 | $16,595.87 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,862.09 | Professional | None | $776.25 | $912.01 | $1,862.09 |
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 $630.96 Median $933.25 Typical High $1,862.09 | Professional | None | $630.96 | $933.25 | $1,862.09 |
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 $758.58 Median $912.01 Typical High $1,548.82 | Professional | None | $758.58 | $912.01 | $1,548.82 |
Well Sense Setting Facility Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,585.78 | $7,585.78 | $7,585.78 |
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 $309.03 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $436.52 | $501.19 | $501.19 |
Where New Hampshire sits
The same service costs 10.1 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 $19,890MT $1,977
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.