How much rates vary
Facilitymedian $3,467 · 10th to 90th $776 to $12,589Professionalmedian $2,089 · 10th to 90th $1,318 to $3,311
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 $1,318.26 Median $1,380.38 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,380.38 | $1,479.11 |
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 $1,479.11 Median $2,398.83 Typical High $3,019.95 | Professional | None | $1,479.11 | $2,398.83 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,380.38 Typical High $1,862.09 | Professional | 62 · Two surgeons | $831.76 | $1,380.38 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $346.74 Typical High $467.74 | Professional | 80 · Assistant surgeon | $213.80 | $346.74 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $302.00 Typical High $407.38 | Professional | AS · PA/NP assist | $186.21 | $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 $2,398.83 Typical High $3,388.44 | Professional | None | $1,445.44 | $2,398.83 | $3,388.44 |
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 $1,318.26 Median $1,819.70 Typical High $3,548.13 | Professional | None | $1,318.26 | $1,819.70 | $3,548.13 |
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 $1,288.25 Median $1,778.28 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,778.28 | $3,715.35 |
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 $660.69 Median $691.83 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,047.13 |
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· 13th of 51
$2,089
AK $4,571TX $851
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.