How much rates vary
Facilitymedian $5,012 · 10th to 90th $776 to $27,542Professionalmedian $7,244 · 10th to 90th $4,571 to $11,220
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 $4,570.88 Median $4,677.35 Typical High $5,128.61 | Professional | None | $4,570.88 | $4,677.35 | $5,128.61 |
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 $4,786.30 Median $8,128.31 Typical High $10,471.29 | Professional | None | $4,786.30 | $8,128.31 | $10,471.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,884.03 Median $4,677.35 Typical High $6,309.57 | Professional | 62 · Two surgeons | $2,884.03 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $724.44 Median $1,202.26 Typical High $1,621.81 | Professional | 80 · Assistant surgeon | $724.44 | $1,202.26 | $1,621.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $630.96 Median $1,047.13 Typical High $1,412.54 | Professional | AS · PA/NP assist | $630.96 | $1,047.13 | $1,412.54 |
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 $3,548.13 Median $8,128.31 Typical High $11,748.98 | Professional | None | $3,548.13 | $8,128.31 | $11,748.98 |
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 $4,570.88 Median $6,165.95 Typical High $12,589.25 | Professional | None | $4,570.88 | $6,165.95 | $12,589.25 |
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 $4,168.69 Median $6,165.95 Typical High $12,882.50 | Professional | None | $4,168.69 | $6,165.95 | $12,882.50 |
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 $2,238.72 Median $2,344.23 Typical High $2,570.40 | Professional | 52 · Reduced service | $2,238.72 | $2,344.23 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $912.01 Median $933.25 Typical High $1,023.29 | Professional | 53 · Discontinued | $912.01 | $933.25 | $1,023.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,548.13 Typical High $3,801.89 | Professional | 54 · Surgery only | $3,388.44 | $3,548.13 | $3,801.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $707.95 Typical High $758.58 | Professional | 55 · Aftercare only | $676.08 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $457.09 Median $467.74 Typical High $512.86 | Professional | 56 · Pre-op care only | $457.09 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,311.31 Typical High $3,548.13 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,311.31 | $3,548.13 |
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
$7,244
AK $15,136TX $692
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.