How much rates vary
Facilitymedian $5,012 · 10th to 90th $776 to $29,512Professionalmedian $1,950 · 10th to 90th $1,288 to $3,311
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 $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,659.59 | $1,659.59 |
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 $1,513.56 Median $2,344.23 Typical High $3,467.37 | Professional | None | $1,513.56 | $2,344.23 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,445.44 Typical High $2,187.76 | Professional | 62 · Two surgeons | $954.99 | $1,445.44 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $371.54 Typical High $549.54 | Professional | 80 · Assistant surgeon | $239.88 | $371.54 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $323.59 Typical High $489.78 | Professional | AS · PA/NP assist | $213.80 | $323.59 | $489.78 |
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 $1,513.56 Median $1,949.84 Typical High $3,715.35 | Professional | None | $1,513.56 | $1,949.84 | $3,715.35 |
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 $1,819.70 Typical High $3,162.28 | Professional | None | $1,230.27 | $1,819.70 | $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 $1,380.38 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,737.80 | $3,019.95 |
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 $616.60 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $616.60 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $245.47 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $933.25 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $186.21 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $123.03 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $870.96 | $1,174.90 | $1,174.90 |
Where New Hampshire sits
The same service costs 6.5 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· 11th of 51
$1,950
AK $5,012TX $776
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.