How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $16,218Professionalmedian $3,981 · 10th to 90th $2,455 to $6,166
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 $2,344.23 Median $2,454.71 Typical High $2,884.03 | Professional | None | $2,344.23 | $2,454.71 | $2,884.03 |
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 $2,630.27 Median $4,365.16 Typical High $5,754.40 | Professional | None | $2,630.27 | $4,365.16 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,630.27 Typical High $3,548.13 | Professional | 62 · Two surgeons | $1,584.89 | $2,630.27 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $660.69 Typical High $891.25 | Professional | 80 · Assistant surgeon | $398.11 | $660.69 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $588.84 Typical High $794.33 | Professional | AS · PA/NP assist | $346.74 | $588.84 | $794.33 |
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 $2,691.53 Median $4,570.88 Typical High $6,456.54 | Professional | None | $2,691.53 | $4,570.88 | $6,456.54 |
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 $2,511.89 Median $3,467.37 Typical High $6,606.93 | Professional | None | $2,511.89 | $3,467.37 | $6,606.93 |
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 $2,570.40 Median $3,388.44 Typical High $6,606.93 | Professional | None | $2,570.40 | $3,388.44 | $6,606.93 |
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 $1,174.90 Median $1,230.27 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,174.90 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $489.78 Typical High $575.44 | Professional | 53 · Discontinued | $467.74 | $489.78 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,862.09 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,778.28 | $1,862.09 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $371.54 Typical High $426.58 | Professional | 55 · Aftercare only | $354.81 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $245.47 Typical High $288.40 | Professional | 56 · Pre-op care only | $234.42 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,737.80 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,737.80 | $1,995.26 |
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· 12th of 51
$3,981
AK $8,318TX $389
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.