How much rates vary
Facilitymedian $5,129 · 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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,000.00 | $1,148.15 | $1,148.15 |
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 $1,348.96 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,348.96 | $2,089.30 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $3,090.30 Typical High $4,365.16 | Professional | 50 · Both sides | $2,041.74 | $3,090.30 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,318.26 Typical High $1,819.70 | Professional | 62 · Two surgeons | $851.14 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $331.13 Typical High $457.09 | Professional | 80 · Assistant surgeon | $218.78 | $331.13 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $288.40 Typical High $407.38 | Professional | AS · PA/NP assist | $190.55 | $288.40 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $6,456.54 Typical High $8,912.51 | Facility | None | $660.69 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,348.96 | $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 $1,096.48 Median $1,621.81 Typical High $3,090.30 | Professional | None | $1,096.48 | $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 $1,174.90 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,174.90 | $1,412.54 | $2,511.89 |
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 $501.19 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $501.19 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $199.53 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $758.58 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $151.36 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $100.00 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $707.95 | $794.33 | $794.33 |
Where New Hampshire sits
The same service costs 5.1 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 $14,362HI $2,794
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.