How much rates vary
Facilitymedian $3,467 · 10th to 90th $776 to $12,589Professionalmedian $6,761 · 10th to 90th $3,890 to $10,471
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 $3,801.89 Median $3,890.45 Typical High $4,570.88 | Professional | None | $3,801.89 | $3,890.45 | $4,570.88 |
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 $4,466.84 Median $7,413.10 Typical High $9,772.37 | Professional | None | $4,466.84 | $7,413.10 | $9,772.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,691.53 Median $4,466.84 Typical High $6,025.60 | Professional | 62 · Two surgeons | $2,691.53 | $4,466.84 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $676.08 Median $1,148.15 Typical High $1,548.82 | Professional | 80 · Assistant surgeon | $676.08 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $588.84 Median $1,000.00 Typical High $1,348.96 | Professional | AS · PA/NP assist | $588.84 | $1,000.00 | $1,348.96 |
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 $4,365.16 Median $7,762.47 Typical High $10,715.19 | Professional | None | $4,365.16 | $7,762.47 | $10,715.19 |
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 $4,265.80 Median $5,888.44 Typical High $10,964.78 | Professional | None | $4,265.80 | $5,888.44 | $10,964.78 |
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 $4,265.80 Median $5,888.44 Typical High $10,964.78 | Professional | None | $4,265.80 | $5,888.44 | $10,964.78 |
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 $1,905.46 Median $1,949.84 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,905.46 | $1,949.84 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $776.25 Typical High $912.01 | Professional | 53 · Discontinued | $758.58 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $2,951.21 Typical High $3,388.44 | Professional | 54 · Surgery only | $2,818.38 | $2,951.21 | $3,388.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $588.84 Typical High $676.08 | Professional | 55 · Aftercare only | $562.34 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $389.05 Typical High $457.09 | Professional | 56 · Pre-op care only | $380.19 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $2,754.23 Typical High $3,162.28 | Professional | 78 · Unplanned return to OR | $2,630.27 | $2,754.23 | $3,162.28 |
Where New Hampshire sits
The same service costs 21.9 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· 12th of 51
$6,761
AK $14,125TX $646
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.