How much rates vary
Facilitymedian $6,166 · 10th to 90th $2,399 to $11,749Professionalmedian $955 · 10th to 90th $676 to $1,738
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 $724.44 Median $2,398.83 Typical High $11,481.54 | Facility | None | $724.44 | $2,398.83 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | None | $645.65 | $724.44 | $724.44 |
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 $812.83 Median $1,230.27 Typical High $1,737.80 | Professional | None | $812.83 | $1,230.27 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,862.09 Typical High $2,570.40 | Professional | 50 · Both sides | $1,202.26 | $1,862.09 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $776.25 Typical High $1,096.48 | Professional | 62 · Two surgeons | $501.19 | $776.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $194.98 Typical High $275.42 | Professional | 80 · Assistant surgeon | $128.82 | $194.98 | $275.42 |
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 $8,128.31 Typical High $11,220.18 | Facility | None | $660.69 | $8,128.31 | $11,220.18 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,905.46 | Professional | None | $812.83 | $954.99 | $1,905.46 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,862.09 | Professional | None | $645.65 | $977.24 | $1,862.09 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $776.25 Median $933.25 Typical High $1,584.89 | Professional | None | $776.25 | $933.25 | $1,584.89 |
Well Sense Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $316.23 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $316.23 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $478.63 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $95.50 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $64.57 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $446.68 | $501.19 | $501.19 |
Where New Hampshire sits
The same service costs 6.8 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 $13,753MT $2,023
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.