How much rates vary
Facilitymedian $5,129 · 10th to 90th $2,344 to $11,220Professionalmedian $1,905 · 10th to 90th $1,318 to $3,467
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 $3,890.45 Typical High $15,848.93 | Facility | None | $2,398.83 | $3,890.45 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,318.26 | $1,479.11 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $10,000.00 Typical High $18,197.01 | Facility | None | $8,912.51 | $10,000.00 | $18,197.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,479.11 | $2,454.71 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,548.82 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,000.00 | $1,548.82 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $389.05 Typical High $562.34 | Professional | 80 · Assistant surgeon | $257.04 | $389.05 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $338.84 Typical High $489.78 | Professional | AS · PA/NP assist | $223.87 | $338.84 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $6,456.54 Typical High $8,912.51 | Facility | None | $933.25 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $3,890.45 | Professional | None | $1,584.89 | $1,905.46 | $3,890.45 |
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 $1,288.25 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,288.25 | $1,905.46 | $3,801.89 |
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 $1,445.44 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,778.28 | $3,235.94 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $660.69 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $263.03 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,047.13 |
Where New Hampshire 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.