How much rates vary
Facilitymedian $5,012 · 10th to 90th $2,344 to $12,589Professionalmedian $1,622 · 10th to 90th $1,096 to $2,951
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,513.56 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $5,623.41 Typical High $9,332.54 | Facility | None | $5,011.87 | $5,623.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,949.84 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,230.27 Typical High $1,862.09 | Professional | 62 · Two surgeons | $812.83 | $1,230.27 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $316.23 Typical High $467.74 | Professional | 80 · Assistant surgeon | $204.17 | $316.23 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $275.42 Typical High $407.38 | Professional | AS · PA/NP assist | $177.83 | $275.42 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $11,481.54 Typical High $15,848.93 | Facility | None | $575.44 | $11,481.54 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,659.59 | $3,162.28 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,047.13 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,047.13 | $1,548.82 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,445.44 | $2,570.40 |
Well Sense Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $549.54 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $223.87 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $831.76 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $165.96 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $112.20 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $776.25 | $1,047.13 | $1,047.13 |
Where New Hampshire sits
The same service costs 6.2 times more in Alaska than in Utah. 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· 15th of 51
$1,660
AK $4,266UT $692
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.