How much rates vary
Facilitymedian $6,607 · 10th to 90th $2,399 to $19,953Professionalmedian $1,175 · 10th to 90th $832 to $2,138
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 $933.25 Median $2,398.83 Typical High $14,791.08 | Facility | None | $933.25 | $2,398.83 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $933.25 | Professional | None | $794.33 | $933.25 | $933.25 |
Ambetter Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
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 $977.24 Median $1,513.56 Typical High $2,137.96 | Professional | None | $977.24 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $2,238.72 Typical High $3,162.28 | Professional | 50 · Both sides | $1,479.11 | $2,238.72 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $954.99 Typical High $1,348.96 | Professional | 62 · Two surgeons | $616.60 | $954.99 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $239.88 Typical High $338.84 | Professional | 80 · Assistant surgeon | $158.49 | $239.88 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $208.93 Typical High $295.12 | Professional | AS · PA/NP assist | $162.18 | $208.93 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $16,595.87 Typical High $22,387.21 | Facility | None | $812.83 | $16,595.87 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,174.90 | $2,344.23 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,912.51 | Facility | None | $2,691.53 | $3,890.45 | $8,912.51 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $794.33 Median $1,202.26 Typical High $2,344.23 | Professional | None | $794.33 | $1,202.26 | $2,344.23 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,912.51 | Facility | None | $2,691.53 | $4,786.30 | $8,912.51 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,949.84 | Professional | None | $954.99 | $1,148.15 | $1,949.84 |
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 $398.11 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $398.11 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $602.56 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $562.34 | $645.65 | $645.65 |
Where New Hampshire sits
The same service costs 9.3 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 $23,115MT $2,489
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.