How much rates vary
Facilitymedian $5,495 · 10th to 90th $2,344 to $11,482Professionalmedian $1,072 · 10th to 90th $724 to $1,862
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 $691.83 Median $812.83 Typical High $812.83 | Professional | None | $691.83 | $812.83 | $812.83 |
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 $851.14 Median $1,288.25 Typical High $1,862.09 | Professional | None | $851.14 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,949.84 Typical High $2,754.23 | Professional | 50 · Both sides | $1,258.93 | $1,949.84 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $208.93 Typical High $295.12 | Professional | 80 · Assistant surgeon | $134.90 | $208.93 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $181.97 Typical High $257.04 | Professional | AS · PA/NP assist | $117.49 | $181.97 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $8,317.64 Typical High $11,481.54 | Facility | None | $660.69 | $8,317.64 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $2,041.74 | Professional | None | $851.14 | $1,023.29 | $2,041.74 |
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 $691.83 Median $1,071.52 Typical High $1,995.26 | Professional | None | $691.83 | $1,071.52 | $1,995.26 |
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 $870.96 Median $1,122.02 Typical High $1,698.24 | Professional | None | $870.96 | $1,122.02 | $1,698.24 |
Well Sense Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,715.35 | Facility | None | $3,715.35 | $3,715.35 | $3,715.35 |
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 $346.74 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $478.63 | $575.44 | $575.44 |
Where New Hampshire sits
The same service costs 6.4 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 $13,837MT $2,168
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.