How much rates vary
Facilitymedian $5,248 · 10th to 90th $2,344 to $11,220Professionalmedian $1,585 · 10th to 90th $1,122 to $2,884
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 $5,370.32 Typical High $22,387.21 | Facility | None | $2,398.83 | $5,370.32 | $22,387.21 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
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 $1,318.26 Median $2,041.74 Typical High $2,884.03 | Professional | None | $1,318.26 | $2,041.74 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $3,019.95 Typical High $4,365.16 | Professional | 50 · Both sides | $1,995.26 | $3,019.95 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,258.93 Typical High $1,819.70 | Professional | 62 · Two surgeons | $831.76 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $323.59 Typical High $467.74 | Professional | 80 · Assistant surgeon | $213.80 | $323.59 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $281.84 Typical High $407.38 | Professional | AS · PA/NP assist | $186.21 | $281.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $6,456.54 Typical High $8,912.51 | Facility | None | $1,288.25 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,584.89 | $3,235.94 |
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 $1,071.52 Median $1,621.81 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,621.81 | $3,090.30 |
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 $1,258.93 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,258.93 | $1,513.56 | $2,630.27 |
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 $549.54 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $870.96 | $870.96 |
Where New Hampshire sits
The same service costs 4.2 times more in Colorado 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
CO $14,362MT $3,396
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.