How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,344 to $16,218Professionalmedian $2,089 · 10th to 90th $1,288 to $3,236
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 $1,230.27 Median $1,288.25 Typical High $1,318.26 | Professional | None | $1,230.27 | $1,288.25 | $1,318.26 |
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 $1,380.38 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,380.38 | $2,290.87 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,380.38 Typical High $1,862.09 | Professional | 62 · Two surgeons | $812.83 | $1,380.38 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $346.74 Typical High $467.74 | Professional | 80 · Assistant surgeon | $208.93 | $346.74 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $302.00 Typical High $407.38 | Professional | AS · PA/NP assist | $181.97 | $302.00 | $407.38 |
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 $1,445.44 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,445.44 | $2,344.23 | $3,311.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,318.26 | $1,778.28 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $3,467.37 | Professional | None | $1,348.96 | $1,778.28 | $3,467.37 |
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 $616.60 Median $645.65 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $645.65 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $257.04 Typical High $263.03 | Professional | 53 · Discontinued | $245.47 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $954.99 Typical High $1,000.00 | Professional | 54 · Surgery only | $912.01 | $954.99 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $190.55 Typical High $199.53 | Professional | 55 · Aftercare only | $181.97 | $190.55 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $128.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $123.03 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $891.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $851.14 | $891.25 | $933.25 |
Where New Hampshire sits
The same service costs 26.3 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
$2,089
AK $5,248TX $200
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.