How much rates vary
Facilitymedian $3,236 · 10th to 90th $2,188 to $6,310Professionalmedian $891 · 10th to 90th $617 to $1,622
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 $676.08 Median $2,398.83 Typical High $15,848.93 | Facility | None | $676.08 | $2,398.83 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $758.58 | Professional | None | $588.84 | $676.08 | $758.58 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $295.12 | Professional | None | $40.74 | $40.74 | $295.12 |
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 $758.58 Median $1,174.90 Typical High $1,621.81 | Professional | None | $758.58 | $1,174.90 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,737.80 Typical High $2,398.83 | Professional | 50 · Both sides | $1,148.15 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $741.31 Typical High $1,023.29 | Professional | 62 · Two surgeons | $478.63 | $741.31 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $186.21 Typical High $257.04 | Professional | 80 · Assistant surgeon | $123.03 | $186.21 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $162.18 Typical High $223.87 | Professional | AS · PA/NP assist | $107.15 | $162.18 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $3,981.07 | Facility | None | $933.25 | $3,162.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,819.70 | Professional | None | $741.31 | $891.25 | $1,819.70 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $616.60 Median $912.01 Typical High $1,778.28 | Professional | None | $616.60 | $912.01 | $1,778.28 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,479.11 | Professional | None | $660.69 | $812.83 | $1,479.11 |
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 $302.00 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $302.00 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $60.26 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $416.87 | $467.74 | $467.74 |
Where New Hampshire sits
The same service costs 3.9 times more in Wisconsin 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
WI $7,471MT $1,932
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.