How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $16,218Professionalmedian $2,455 · 10th to 90th $1,514 to $3,802
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 $1,445.44 Median $1,513.56 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,513.56 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $10,000.00 Typical High $16,982.44 | Facility | None | $3,890.45 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,691.53 Typical High $3,630.78 | Professional | None | $1,621.81 | $2,691.53 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,621.81 Typical High $2,187.76 | Professional | 62 · Two surgeons | $977.24 | $1,621.81 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $416.87 Typical High $562.34 | Professional | 80 · Assistant surgeon | $245.47 | $416.87 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $363.08 Typical High $489.78 | Professional | AS · PA/NP assist | $218.78 | $363.08 | $489.78 |
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 $1,621.81 Median $2,818.38 Typical High $3,981.07 | Professional | None | $1,621.81 | $2,818.38 | $3,981.07 |
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 $1,548.82 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,548.82 | $2,137.96 | $4,168.69 |
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 $1,584.89 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,584.89 | $2,089.30 | $4,168.69 |
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 $724.44 Median $758.58 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $354.81 | Professional | 53 · Discontinued | $288.40 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,096.48 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $269.15 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,071.52 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,071.52 | $1,230.27 |
Where New Hampshire sits
The same service costs 20.9 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
$2,455
AK $5,129TX $245
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.