How much rates vary
Facilitymedian $3,162 · 10th to 90th $2,188 to $6,310Professionalmedian $977 · 10th to 90th $692 to $1,778
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 $660.69 Median $741.31 Typical High $741.31 | Professional | None | $660.69 | $741.31 | $741.31 |
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 $812.83 Median $1,230.27 Typical High $1,778.28 | Professional | None | $812.83 | $1,230.27 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,862.09 Typical High $2,630.27 | Professional | 50 · Both sides | $1,202.26 | $1,862.09 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $199.53 Typical High $281.84 | Professional | 80 · Assistant surgeon | $128.82 | $199.53 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $173.78 Typical High $239.88 | Professional | AS · PA/NP assist | $112.20 | $173.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,884.03 Typical High $3,981.07 | Facility | None | $660.69 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,995.26 | Professional | None | $812.83 | $977.24 | $1,995.26 |
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 $660.69 Median $977.24 Typical High $1,905.46 | Professional | None | $660.69 | $977.24 | $1,905.46 |
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 $794.33 Median $954.99 Typical High $1,621.81 | Professional | None | $794.33 | $954.99 | $1,621.81 |
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 $331.13 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $331.13 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $97.72 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $66.07 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $524.81 |
Where New Hampshire sits
The same service costs 3.7 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 $7,647MT $2,070
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.