How much rates vary
Facilitymedian $5,012 · 10th to 90th $776 to $27,542Professionalmedian $5,754 · 10th to 90th $3,631 to $9,120
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $3,801.89 Typical High $4,073.80 | Professional | None | $3,630.78 | $3,801.89 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $16,595.87 Typical High $28,840.32 | Facility | None | $5,623.41 | $16,595.87 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,890.45 Median $6,606.93 Typical High $8,317.64 | Professional | None | $3,890.45 | $6,606.93 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,290.87 Median $3,801.89 Typical High $5,128.61 | Professional | 62 · Two surgeons | $2,290.87 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $954.99 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $588.84 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $851.14 Typical High $1,122.02 | Professional | AS · PA/NP assist | $512.86 | $851.14 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $2,691.53 | Facility | None | $489.78 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $3,235.94 Median $6,456.54 Typical High $9,549.93 | Professional | None | $3,235.94 | $6,456.54 | $9,549.93 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $851.14 Typical High $2,884.03 | Facility | None | $776.25 | $851.14 | $2,884.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3,715.35 Median $5,011.87 Typical High $10,000.00 | Professional | None | $3,715.35 | $5,011.87 | $10,000.00 |
United Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $2,884.03 | Facility | None | $776.25 | $933.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $3,388.44 Median $5,011.87 Typical High $10,471.29 | Professional | None | $3,388.44 | $5,011.87 | $10,471.29 |
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 $1,819.70 Median $1,905.46 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,819.70 | $1,905.46 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $758.58 Typical High $812.83 | Professional | 53 · Discontinued | $724.44 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,754.23 Median $2,884.03 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,754.23 | $2,884.03 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $549.54 Median $575.44 Typical High $616.60 | Professional | 55 · Aftercare only | $549.54 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $380.19 Typical High $407.38 | Professional | 56 · Pre-op care only | $363.08 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,570.40 Median $2,691.53 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,570.40 | $2,691.53 | $2,884.03 |
Where New Hampshire sits
The same service costs 21.9 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· 12th of 51
$5,754
AK $12,303TX $562
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.