How much rates vary
Facilitymedian $5,012 · 10th to 90th $776 to $29,512Professionalmedian $1,738 · 10th to 90th $1,202 to $3,090
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 $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $18,197.01 Typical High $30,902.95 | Facility | None | $5,623.41 | $18,197.01 | $30,902.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,479.11 | $2,238.72 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $3,388.44 Typical High $4,677.35 | Professional | 50 · Both sides | $2,187.76 | $3,388.44 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,412.54 Typical High $1,949.84 | Professional | 62 · Two surgeons | $933.25 | $1,412.54 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $363.08 Typical High $501.19 | Professional | 80 · Assistant surgeon | $234.42 | $363.08 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $316.23 Typical High $436.52 | Professional | AS · PA/NP assist | $204.17 | $316.23 | $436.52 |
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 $1,318.26 Median $1,737.80 Typical High $3,311.31 | Professional | None | $1,318.26 | $1,737.80 | $3,311.31 |
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 $1,148.15 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,584.89 | $3,019.95 |
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 $1,096.48 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,479.11 | $2,570.40 |
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 $549.54 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $831.76 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $870.96 |
Where New Hampshire sits
The same service costs 21.9 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
$1,738
AK $4,467TX $204
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.