How much rates vary
Facilitymedian $5,012 · 10th to 90th $776 to $27,542Professionalmedian $4,677 · 10th to 90th $2,818 to $7,244
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 $2,754.23 Median $2,951.21 Typical High $3,235.94 | Professional | None | $2,754.23 | $2,951.21 | $3,235.94 |
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 $3,019.95 Median $5,128.61 Typical High $6,606.93 | Professional | None | $3,019.95 | $5,128.61 | $6,606.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,819.70 Median $3,019.95 Typical High $4,073.80 | Professional | 62 · Two surgeons | $1,819.70 | $3,019.95 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $758.58 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $467.74 | $758.58 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $660.69 Typical High $891.25 | Professional | AS · PA/NP assist | $407.38 | $660.69 | $891.25 |
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 $2,818.38 Median $5,128.61 Typical High $7,413.10 | Professional | None | $2,818.38 | $5,128.61 | $7,413.10 |
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 $2,951.21 Median $3,981.07 Typical High $7,762.47 | Professional | None | $2,951.21 | $3,981.07 | $7,762.47 |
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 $2,691.53 Median $3,890.45 Typical High $7,762.47 | Professional | None | $2,691.53 | $3,890.45 | $7,762.47 |
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 $1,380.38 Median $1,479.11 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,380.38 | $1,479.11 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $588.84 Typical High $645.65 | Professional | 53 · Discontinued | $549.54 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,238.72 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,041.74 | $2,238.72 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $446.68 Typical High $489.78 | Professional | 55 · Aftercare only | $407.38 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $295.12 Typical High $323.59 | Professional | 56 · Pre-op care only | $275.42 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,089.30 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,089.30 | $2,290.87 |
Where New Hampshire sits
The same service costs 5.1 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
$4,677
AK $9,772TX $1,905
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.