How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,698 to $10,000Professionalmedian $977 · 10th to 90th $692 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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
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 $1,230.27 Median $1,862.09 Typical High $2,630.27 | Professional | 50 · Both sides | $1,230.27 | $1,862.09 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $776.25 Typical High $1,096.48 | Professional | 62 · Two surgeons | $512.86 | $776.25 | $1,096.48 |
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 $114.82 Median $173.78 Typical High $245.47 | Professional | AS · PA/NP assist | $114.82 | $173.78 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $6,456.54 Typical High $8,912.51 | Facility | None | $575.44 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,949.84 | Professional | None | $812.83 | $954.99 | $1,949.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
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 $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,584.89 | Professional | None | $741.31 | $891.25 | $1,584.89 |
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 $323.59 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $323.59 | $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 $489.78 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $489.78 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $97.72 | $109.65 | $109.65 |
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 $457.09 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $457.09 | $512.86 | $512.86 |
Where New Hampshire sits
The same service costs 5.4 times more in Colorado than in Delaware. 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 $10,891DE $2,015
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.