How much rates vary
Facilitymedian $5,012 · 10th to 90th $2,344 to $9,550Professionalmedian $2,042 · 10th to 90th $1,413 to $3,715
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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,949.84 | $1,949.84 |
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 $1,513.56 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,513.56 | $2,454.71 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,548.82 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,000.00 | $1,548.82 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $389.05 Typical High $588.84 | Professional | 80 · Assistant surgeon | $257.04 | $389.05 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $346.74 Typical High $512.86 | Professional | AS · PA/NP assist | $223.87 | $346.74 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $7,244.36 Typical High $10,000.00 | Facility | None | $660.69 | $7,244.36 | $10,000.00 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $3,981.07 | Professional | None | $1,621.81 | $2,089.30 | $3,981.07 |
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 $1,318.26 Median $1,949.84 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,949.84 | $3,890.45 |
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 $1,445.44 Median $1,819.70 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,819.70 | $3,311.31 |
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 $707.95 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $707.95 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $281.84 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,047.13 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $208.93 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $141.25 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $977.24 | $1,348.96 | $1,348.96 |
Where New Hampshire sits
The same service costs 11.0 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· 14th of 51
$2,089
AK $5,370TX $490
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.