How much rates vary
Facilitymedian $4,074 · 10th to 90th $2,692 to $6,607Professionalmedian $1,413 · 10th to 90th $955 to $2,512
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 $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | None | $933.25 | $1,047.13 | $1,047.13 |
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 $1,096.48 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,819.70 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,754.23 Typical High $3,801.89 | Professional | 50 · Both sides | $1,778.28 | $2,754.23 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $1,148.15 Typical High $1,621.81 | Professional | 62 · Two surgeons | $741.31 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $288.40 Typical High $407.38 | Professional | 80 · Assistant surgeon | $190.55 | $288.40 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $257.04 Typical High $354.81 | Professional | AS · PA/NP assist | $165.96 | $257.04 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,981.07 Typical High $5,011.87 | Facility | None | $630.96 | $3,981.07 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,412.54 | $2,818.38 |
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 $954.99 Median $1,348.96 Typical High $2,454.71 | Professional | None | $954.99 | $1,348.96 | $2,454.71 |
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 $1,023.29 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,258.93 | $2,290.87 |
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 $467.74 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $467.74 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $93.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $724.44 |
Where New Hampshire sits
The same service costs 5.0 times more in Oklahoma than in Texas. 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
OK $11,096TX $2,225
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.