How much rates vary
Facilitymedian $3,467 · 10th to 90th $776 to $12,589Professionalmedian $2,692 · 10th to 90th $1,660 to $4,266
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 $1,584.89 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,659.59 | $1,949.84 |
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 $1,778.28 Median $3,019.95 Typical High $3,890.45 | Professional | None | $1,778.28 | $3,019.95 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,778.28 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,047.13 | $1,778.28 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $446.68 Typical High $602.56 | Professional | 80 · Assistant surgeon | $269.15 | $446.68 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $389.05 Typical High $524.81 | Professional | AS · PA/NP assist | $234.42 | $389.05 | $524.81 |
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 $3,090.30 Typical High $4,365.16 | Professional | None | $1,778.28 | $3,090.30 | $4,365.16 |
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 $1,737.80 Median $2,344.23 Typical High $4,466.84 | Professional | None | $1,737.80 | $2,344.23 | $4,466.84 |
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 $1,737.80 Median $2,290.87 Typical High $4,466.84 | Professional | None | $1,737.80 | $2,290.87 | $4,466.84 |
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 $794.33 Median $812.83 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $331.13 Typical High $389.05 | Professional | 53 · Discontinued | $316.23 | $331.13 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,230.27 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $239.88 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $165.96 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,148.15 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,148.15 | $1,348.96 |
Where New Hampshire sits
The same service costs 20.4 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
$2,692
AK $5,495TX $269
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.