How much rates vary
Facilitymedian $5,012 · 10th to 90th $776 to $27,542Professionalmedian $4,677 · 10th to 90th $2,884 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 $2,570.40 Median $2,884.03 Typical High $3,090.30 | Professional | None | $2,570.40 | $2,884.03 | $3,090.30 |
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 $2,884.03 Median $5,128.61 Typical High $6,760.83 | Professional | None | $2,884.03 | $5,128.61 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,778.28 Median $3,090.30 Typical High $4,168.69 | Professional | 62 · Two surgeons | $1,778.28 | $3,090.30 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $776.25 Typical High $1,047.13 | Professional | 80 · Assistant surgeon | $446.68 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $691.83 Typical High $933.25 | Professional | AS · PA/NP assist | $398.11 | $691.83 | $933.25 |
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 $3,235.94 Median $5,370.32 Typical High $7,413.10 | Professional | None | $3,235.94 | $5,370.32 | $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 $7,413.10 | Professional | None | $2,951.21 | $3,981.07 | $7,413.10 |
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 $2,884.03 Median $3,715.35 Typical High $7,413.10 | Professional | None | $2,884.03 | $3,715.35 | $7,413.10 |
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 $1,288.25 Median $1,445.44 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,288.25 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $575.44 Typical High $630.96 | Professional | 53 · Discontinued | $512.86 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,137.96 Typical High $2,344.23 | Professional | 54 · Surgery only | $1,949.84 | $2,137.96 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $426.58 Typical High $467.74 | Professional | 55 · Aftercare only | $389.05 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | 56 · Pre-op care only | $257.04 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,995.26 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,995.26 | $2,187.76 |
Where New Hampshire sits
The same service costs 21.4 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
$4,677
AK $9,772TX $457
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.