How much rates vary
Facilitymedian $5,012 · 10th to 90th $2,344 to $9,550Professionalmedian $2,188 · 10th to 90th $1,514 to $3,981
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 $1,621.81 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,621.81 | $2,137.96 | $2,137.96 |
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 $1,621.81 Median $2,630.27 Typical High $3,981.07 | Professional | None | $1,621.81 | $2,630.27 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,659.59 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,096.48 | $1,659.59 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $426.58 Typical High $630.96 | Professional | 80 · Assistant surgeon | $275.42 | $426.58 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $371.54 Typical High $549.54 | Professional | AS · PA/NP assist | $239.88 | $371.54 | $549.54 |
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 $1,778.28 Median $2,238.72 Typical High $4,265.80 | Professional | None | $1,778.28 | $2,238.72 | $4,265.80 |
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 $1,412.54 Median $2,089.30 Typical High $4,168.69 | Professional | None | $1,412.54 | $2,089.30 | $4,168.69 |
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 $1,548.82 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,548.82 | $1,949.84 | $3,548.13 |
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 $812.83 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $812.83 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $323.59 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,202.26 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $245.47 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $162.18 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,513.56 | $1,513.56 |
Where New Hampshire sits
The same service costs 24.5 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· 15th of 51
$2,239
AK $5,754TX $234
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.