How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $16,218Professionalmedian $1,820 · 10th to 90th $1,148 to $2,884
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 $1,071.52 Median $1,148.15 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,148.15 | $1,318.26 |
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 $1,202.26 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,202.26 | $2,041.74 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,202.26 Typical High $1,621.81 | Professional | 62 · Two surgeons | $724.44 | $1,202.26 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $309.03 Typical High $416.87 | Professional | 80 · Assistant surgeon | $181.97 | $309.03 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $269.15 Typical High $363.08 | Professional | AS · PA/NP assist | $162.18 | $269.15 | $363.08 |
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 $1,258.93 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,258.93 | $2,089.30 | $2,951.21 |
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 $1,174.90 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,584.89 | $3,090.30 |
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 $1,202.26 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,584.89 | $3,090.30 |
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 $537.03 Median $562.34 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $229.09 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $851.14 Typical High $1,000.00 | Professional | 54 · Surgery only | $812.83 | $851.14 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $131.83 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $794.33 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $758.58 | $794.33 | $933.25 |
Where New Hampshire sits
The same service costs 5.6 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· 14th of 51
$1,820
AK $4,266TX $759
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.