How much rates vary
Facilitymedian $1,738 · 10th to 90th $776 to $7,762Professionalmedian $1,995 · 10th to 90th $1,202 to $3,090
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 $1,148.15 Median $1,202.26 Typical High $1,412.54 | Professional | None | $1,148.15 | $1,202.26 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $4,570.88 Typical High $7,943.28 | Facility | None | $1,698.24 | $4,570.88 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,258.93 | $2,089.30 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,288.25 Typical High $1,737.80 | Professional | 62 · Two surgeons | $758.58 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $331.13 Typical High $446.68 | Professional | 80 · Assistant surgeon | $194.98 | $331.13 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $288.40 Typical High $389.05 | Professional | AS · PA/NP assist | $169.82 | $288.40 | $389.05 |
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 $1,318.26 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,318.26 | $2,238.72 | $3,162.28 |
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 $1,258.93 Median $1,698.24 Typical High $3,311.31 | Professional | None | $1,258.93 | $1,698.24 | $3,311.31 |
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 $1,258.93 Median $1,659.59 Typical High $3,311.31 | Professional | None | $1,258.93 | $1,659.59 | $3,311.31 |
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 $575.44 Median $602.56 Typical High $707.95 | Professional | 52 · Reduced service | $575.44 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $912.01 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $141.25 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $1,000.00 |
Where New Hampshire sits
The same service costs 5.9 times more in Alabama than in Maryland. 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.
Physician feeFacility fee
AL $10,682MD $1,821
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.