How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $16,218Professionalmedian $2,188 · 10th to 90th $1,318 to $3,388
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 $1,288.25 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,288.25 | $1,318.26 | $1,548.82 |
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 $1,479.11 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,479.11 | $2,344.23 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,412.54 Typical High $1,905.46 | Professional | 62 · Two surgeons | $851.14 | $1,412.54 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $363.08 Typical High $489.78 | Professional | 80 · Assistant surgeon | $213.80 | $363.08 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $316.23 Typical High $426.58 | Professional | AS · PA/NP assist | $190.55 | $316.23 | $426.58 |
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 $2,454.71 Typical High $3,467.37 | Professional | None | $1,445.44 | $2,454.71 | $3,467.37 |
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 $1,380.38 Median $1,862.09 Typical High $3,630.78 | Professional | None | $1,380.38 | $1,862.09 | $3,630.78 |
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 $1,380.38 Median $1,862.09 Typical High $3,630.78 | Professional | None | $1,380.38 | $1,862.09 | $3,630.78 |
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 $645.65 Median $660.69 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $257.04 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $1,096.48 |
Where New Hampshire sits
The same service costs 5.0 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
$2,188
AK $4,467TX $891
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.