How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,148 to $6,026Professionalmedian $1,622 · 10th to 90th $1,259 to $2,455
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 Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,621.81 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,258.93 | $1,659.59 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,047.13 Typical High $1,548.82 | Professional | 62 · Two surgeons | $794.33 | $1,047.13 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $263.03 Typical High $398.11 | Professional | 80 · Assistant surgeon | $199.53 | $263.03 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $229.09 Typical High $346.74 | Professional | AS · PA/NP assist | $177.83 | $229.09 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $4,168.69 Typical High $6,606.93 | Facility | None | $1,148.15 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,778.28 | $2,570.40 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,621.81 | $2,290.87 |
Martin's Point Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,288.25 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,621.81 | $2,137.96 |
12 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 $660.69 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $1,122.02 | $1,122.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $758.58 | $812.83 | $812.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $302.00 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,122.02 | $1,202.26 | $1,202.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $223.87 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $151.36 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,122.02 | $1,122.02 |
Where Maine sits
The same service costs 4.0 times more in Colorado than in Hawaii. 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
CO $14,661HI $3,664
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.