How much rates vary
Facilitymedian $3,802 · 10th to 90th $776 to $16,218Professionalmedian $2,884 · 10th to 90th $1,778 to $4,571
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 $1,737.80 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,737.80 | $1,778.28 | $1,862.09 |
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 $1,905.46 Median $3,235.94 Typical High $4,265.80 | Professional | None | $1,905.46 | $3,235.94 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,949.84 Typical High $2,570.40 | Professional | 62 · Two surgeons | $1,148.15 | $1,949.84 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $489.78 Typical High $660.69 | Professional | 80 · Assistant surgeon | $295.12 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $426.58 Typical High $575.44 | Professional | AS · PA/NP assist | $257.04 | $426.58 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $4,786.30 | Facility | None | $489.78 | $630.96 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $3,311.31 Typical High $4,677.35 | Professional | None | $1,995.26 | $3,311.31 | $4,677.35 |
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 $1,862.09 Median $2,511.89 Typical High $4,897.79 | Professional | None | $1,862.09 | $2,511.89 | $4,897.79 |
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 $1,862.09 Median $2,511.89 Typical High $4,897.79 | Professional | None | $1,862.09 | $2,511.89 | $4,897.79 |
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 $870.96 Median $891.25 Typical High $933.25 | Professional | 52 · Reduced service | $870.96 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $363.08 Typical High $371.54 | Professional | 53 · Discontinued | $346.74 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,348.96 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,288.25 | $1,348.96 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $269.15 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,258.93 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,258.93 | $1,288.25 |
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· 14th of 51
$2,884
AK $6,310TX $1,175
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.