How much rates vary
Facilitymedian $7,762 · 10th to 90th $776 to $33,113Professionalmedian $3,981 · 10th to 90th $2,630 to $6,761
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 $2,570.40 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,570.40 | $3,388.44 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $19,952.62 Typical High $34,673.69 | Facility | None | $9,772.37 | $19,952.62 | $34,673.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,235.94 Median $5,011.87 Typical High $7,079.46 | Professional | None | $3,235.94 | $5,011.87 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,041.74 Median $3,162.28 Typical High $4,466.84 | Professional | 62 · Two surgeons | $2,041.74 | $3,162.28 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $524.81 Median $794.33 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $524.81 | $794.33 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $691.83 Typical High $1,000.00 | Professional | AS · PA/NP assist | $457.09 | $691.83 | $1,000.00 |
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 $3,090.30 Median $3,981.07 Typical High $7,585.78 | Professional | None | $3,090.30 | $3,981.07 | $7,585.78 |
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 $2,630.27 Median $3,715.35 Typical High $6,760.83 | Professional | None | $2,630.27 | $3,715.35 | $6,760.83 |
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 $2,630.27 Median $3,388.44 Typical High $6,025.60 | Professional | None | $2,630.27 | $3,388.44 | $6,025.60 |
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 $1,288.25 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,288.25 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $512.86 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,905.46 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $380.19 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $257.04 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,778.28 | $2,398.83 | $2,398.83 |
Where New Hampshire sits
The same service costs 24.0 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· 13th of 51
$3,981
AK $10,233TX $427
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.