How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,698 to $6,166Professionalmedian $776 · 10th to 90th $550 to $1,413
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 $501.19 Median $575.44 Typical High $575.44 | Professional | None | $501.19 | $575.44 | $575.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,677.35 Typical High $6,309.57 | Facility | None | $3,467.37 | $4,677.35 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,412.54 | Professional | None | $776.25 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,513.56 Typical High $2,089.30 | Professional | 50 · Both sides | $1,000.00 | $1,513.56 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $645.65 Typical High $891.25 | Professional | 62 · Two surgeons | $416.87 | $645.65 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $162.18 Typical High $223.87 | Professional | 80 · Assistant surgeon | $107.15 | $162.18 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $141.25 Typical High $194.98 | Professional | AS · PA/NP assist | $93.33 | $141.25 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,884.03 Typical High $3,981.07 | Facility | None | $575.44 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,548.82 | Professional | None | $676.08 | $776.25 | $1,548.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,513.56 | Professional | None | $537.03 | $794.33 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $1,258.93 | Professional | None | $575.44 | $691.83 | $1,258.93 |
Well Sense Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $257.04 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $380.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $354.81 | $398.11 | $398.11 |
Where New Hampshire sits
The same service costs 4.2 times more in Alabama than in Montana. 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.
Physician feeFacility fee
AL $7,045MT $1,664
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.