How much rates vary
Facilitymedian $3,802 · 10th to 90th $776 to $15,849Professionalmedian $2,399 · 10th to 90th $1,445 to $3,715
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 $3,890.45 Typical High $15,848.93 | Facility | None | $2,398.83 | $3,890.45 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,318.26 | $1,445.44 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $10,000.00 Typical High $16,982.44 | Facility | None | $3,890.45 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $2,630.27 Typical High $3,388.44 | Professional | None | $1,584.89 | $2,630.27 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,584.89 Typical High $2,137.96 | Professional | 62 · Two surgeons | $954.99 | $1,584.89 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $398.11 Typical High $537.03 | Professional | 80 · Assistant surgeon | $239.88 | $398.11 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $354.81 Typical High $478.63 | Professional | AS · PA/NP assist | $208.93 | $354.81 | $478.63 |
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 $1,584.89 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,584.89 | $2,754.23 | $3,801.89 |
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 $1,513.56 Median $2,041.74 Typical High $3,801.89 | Professional | None | $1,513.56 | $2,041.74 | $3,801.89 |
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 $1,548.82 Median $2,041.74 Typical High $3,801.89 | Professional | None | $1,548.82 | $2,041.74 | $3,801.89 |
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 $724.44 Typical High $758.58 | Professional | 52 · Reduced service | $660.69 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $263.03 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $218.78 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $144.54 Typical High $151.36 | Professional | 56 · Pre-op care only | $131.83 | $144.54 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,047.13 |
Where New Hampshire sits
The same service costs 5.2 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
$2,399
AK $5,129TX $977
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.