How much rates vary
Facilitymedian $5,012 · 10th to 90th $2,344 to $9,550Professionalmedian $2,138 · 10th to 90th $1,445 to $3,802
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 $1,995.26 Typical High $1,995.26 | Professional | None | $1,412.54 | $1,995.26 | $1,995.26 |
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 $2,570.40 Typical High $3,801.89 | Professional | None | $1,621.81 | $2,570.40 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,584.89 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,047.13 | $1,584.89 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $407.38 Typical High $602.56 | Professional | 80 · Assistant surgeon | $263.03 | $407.38 | $602.56 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $354.81 Typical High $537.03 | Professional | AS · PA/NP assist | $234.42 | $354.81 | $537.03 |
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 $1,698.24 Median $2,187.76 Typical High $4,073.80 | Professional | None | $1,698.24 | $2,187.76 | $4,073.80 |
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 $1,348.96 Median $2,041.74 Typical High $3,981.07 | Professional | None | $1,348.96 | $2,041.74 | $3,981.07 |
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 $1,479.11 Median $1,905.46 Typical High $3,630.78 | Professional | None | $1,479.11 | $1,905.46 | $3,630.78 |
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 $288.40 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $288.40 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,479.11 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,071.52 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $213.80 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $141.25 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,380.38 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,380.38 | $1,380.38 |
Where New Hampshire sits
The same service costs 7.2 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· 13th of 51
$2,188
AK $5,495TX $759
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.