How much rates vary
Facilitymedian $7,762 · 10th to 90th $776 to $33,113Professionalmedian $2,951 · 10th to 90th $2,042 to $5,129
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 $1,862.09 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,570.40 | $2,570.40 |
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 $2,187.76 Median $3,801.89 Typical High $5,248.07 | Professional | None | $2,187.76 | $3,801.89 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,398.83 Typical High $3,311.31 | Professional | 62 · Two surgeons | $1,548.82 | $2,398.83 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $602.56 Typical High $851.14 | Professional | 80 · Assistant surgeon | $398.11 | $602.56 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $524.81 Typical High $741.31 | Professional | AS · PA/NP assist | $346.74 | $524.81 | $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 $2,344.23 Median $2,951.21 Typical High $5,623.41 | Professional | None | $2,344.23 | $2,951.21 | $5,623.41 |
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 $2,041.74 Median $2,754.23 Typical High $5,011.87 | Professional | None | $2,041.74 | $2,754.23 | $5,011.87 |
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 $1,995.26 Median $2,511.89 Typical High $4,365.16 | Professional | None | $1,995.26 | $2,511.89 | $4,365.16 |
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 $912.01 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $912.01 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $371.54 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,380.38 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $275.42 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $186.21 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,778.28 | $1,778.28 |
Where New Hampshire sits
The same service costs 22.9 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
$2,951
AK $7,586TX $331
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.