How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $16,218Professionalmedian $3,715 · 10th to 90th $2,291 to $5,754
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 $2,187.76 Median $2,290.87 Typical High $2,691.53 | Professional | None | $2,187.76 | $2,290.87 | $2,691.53 |
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 $2,454.71 Median $4,073.80 Typical High $5,370.32 | Professional | None | $2,454.71 | $4,073.80 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $2,454.71 Typical High $3,311.31 | Professional | 62 · Two surgeons | $1,479.11 | $2,454.71 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $616.60 Typical High $831.76 | Professional | 80 · Assistant surgeon | $371.54 | $616.60 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $549.54 Typical High $741.31 | Professional | AS · PA/NP assist | $331.13 | $549.54 | $741.31 |
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 $2,398.83 Median $4,265.80 Typical High $6,025.60 | Professional | None | $2,398.83 | $4,265.80 | $6,025.60 |
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 $2,344.23 Median $3,235.94 Typical High $6,309.57 | Professional | None | $2,344.23 | $3,235.94 | $6,309.57 |
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 $2,398.83 Median $3,162.28 Typical High $6,309.57 | Professional | None | $2,398.83 | $3,162.28 | $6,309.57 |
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 $1,096.48 Median $1,148.15 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,096.48 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $467.74 Typical High $537.03 | Professional | 53 · Discontinued | $436.52 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $1,737.80 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,659.59 | $1,737.80 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $346.74 Typical High $398.11 | Professional | 55 · Aftercare only | $331.13 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $229.09 Typical High $269.15 | Professional | 56 · Pre-op care only | $218.78 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,621.81 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,621.81 | $1,862.09 |
Where New Hampshire sits
The same service costs 22.4 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
$3,715
AK $7,943TX $355
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.