How much rates vary
Facilitymedian $3,467 · 10th to 90th $776 to $12,589Professionalmedian $2,570 · 10th to 90th $1,585 to $3,981
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 $1,513.56 Median $1,584.89 Typical High $1,737.80 | Professional | None | $1,513.56 | $1,584.89 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $7,762.47 Typical High $13,182.57 | Facility | None | $3,801.89 | $7,762.47 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,819.70 | $2,754.23 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,698.24 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,023.29 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $436.52 Typical High $588.84 | Professional | 80 · Assistant surgeon | $257.04 | $436.52 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $380.19 Typical High $512.86 | Professional | AS · PA/NP assist | $223.87 | $380.19 | $512.86 |
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 $1,778.28 Median $2,951.21 Typical High $4,073.80 | Professional | None | $1,778.28 | $2,951.21 | $4,073.80 |
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 $1,659.59 Median $2,238.72 Typical High $4,365.16 | Professional | None | $1,659.59 | $2,238.72 | $4,365.16 |
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 $1,659.59 Median $2,187.76 Typical High $4,365.16 | Professional | None | $1,659.59 | $2,187.76 | $4,365.16 |
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 $758.58 Median $794.33 Typical High $870.96 | Professional | 52 · Reduced service | $758.58 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $316.23 Typical High $346.74 | Professional | 53 · Discontinued | $302.00 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,202.26 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,202.26 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $239.88 Typical High $263.03 | Professional | 55 · Aftercare only | $229.09 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $158.49 Typical High $173.78 | Professional | 56 · Pre-op care only | $151.36 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,122.02 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,122.02 | $1,202.26 |
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· 13th of 51
$2,570
AK $5,370TX $257
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.