How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $16,218Professionalmedian $1,905 · 10th to 90th $1,175 to $3,020
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 $1,122.02 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,122.02 | $1,174.90 | $1,380.38 |
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 $1,258.93 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,258.93 | $2,041.74 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,258.93 Typical High $1,698.24 | Professional | 62 · Two surgeons | $758.58 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $323.59 Typical High $436.52 | Professional | 80 · Assistant surgeon | $190.55 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $281.84 Typical High $380.19 | Professional | AS · PA/NP assist | $165.96 | $281.84 | $380.19 |
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 $1,230.27 Median $2,187.76 Typical High $3,090.30 | Professional | None | $1,230.27 | $2,187.76 | $3,090.30 |
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 $1,230.27 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,230.27 | $1,659.59 | $3,162.28 |
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 $1,230.27 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,230.27 | $1,621.81 | $3,162.28 |
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 $562.34 Median $588.84 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $588.84 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $234.42 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $851.14 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $177.83 Typical High $208.93 | Professional | 55 · Aftercare only | $169.82 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $117.49 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $954.99 |
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
$1,905
AK $4,266TX $794
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.