How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $16,218Professionalmedian $2,188 · 10th to 90th $1,349 to $3,467
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 $1,348.96 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,348.96 | $1,584.89 |
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 $1,513.56 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,513.56 | $2,344.23 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,445.44 Typical High $1,949.84 | Professional | 62 · Two surgeons | $870.96 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $371.54 Typical High $489.78 | Professional | 80 · Assistant surgeon | $218.78 | $371.54 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $323.59 Typical High $436.52 | Professional | AS · PA/NP assist | $190.55 | $323.59 | $436.52 |
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 $1,479.11 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,479.11 | $2,511.89 | $3,548.13 |
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 $1,412.54 Median $1,905.46 Typical High $3,715.35 | Professional | None | $1,412.54 | $1,905.46 | $3,715.35 |
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 $1,412.54 Median $1,862.09 Typical High $3,715.35 | Professional | None | $1,412.54 | $1,862.09 | $3,715.35 |
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 $676.08 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $676.08 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $269.15 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $204.17 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $134.90 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $1,096.48 |
Where New Hampshire sits
The same service costs 5.4 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
$2,188
AK $4,677TX $871
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.