How much rates vary
Facilitymedian $5,012 · 10th to 90th $776 to $27,542Professionalmedian $2,570 · 10th to 90th $1,622 to $3,981
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 $1,513.56 Median $1,698.24 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,698.24 | $1,819.70 |
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 $1,778.28 Median $2,818.38 Typical High $3,715.35 | Professional | None | $1,778.28 | $2,818.38 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,659.59 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,023.29 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $426.58 Typical High $562.34 | Professional | 80 · Assistant surgeon | $257.04 | $426.58 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $371.54 Typical High $501.19 | Professional | AS · PA/NP assist | $223.87 | $371.54 | $501.19 |
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 $1,905.46 Median $2,884.03 Typical High $4,168.69 | Professional | None | $1,905.46 | $2,884.03 | $4,168.69 |
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 $1,621.81 Median $2,290.87 Typical High $4,365.16 | Professional | None | $1,621.81 | $2,290.87 | $4,365.16 |
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 $1,659.59 Median $2,187.76 Typical High $4,365.16 | Professional | None | $1,659.59 | $2,187.76 | $4,365.16 |
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 $758.58 Median $851.14 Typical High $912.01 | Professional | 52 · Reduced service | $758.58 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $338.84 Typical High $363.08 | Professional | 53 · Discontinued | $302.00 | $338.84 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,258.93 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,148.15 | $1,258.93 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $269.15 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $169.82 Typical High $181.97 | Professional | 56 · Pre-op care only | $151.36 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,174.90 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,174.90 | $1,258.93 |
Where New Hampshire sits
The same service costs 5.4 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· 13th of 51
$2,570
AK $5,623TX $1,047
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.