How much rates vary
Facilitymedian $1,259 · 10th to 90th $813 to $2,291Professionalmedian $759 · 10th to 90th $589 to $1,175
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 Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,148.15 | Professional | None | $616.60 | $758.58 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $794.33 Typical High $1,174.90 | Professional | None | $602.56 | $794.33 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,174.90 Typical High $1,778.28 | Professional | 50 · Both sides | $912.01 | $1,174.90 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $501.19 Typical High $741.31 | Professional | 62 · Two surgeons | $380.19 | $501.19 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $125.89 Typical High $190.55 | Professional | 80 · Assistant surgeon | $97.72 | $125.89 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $109.65 Typical High $165.96 | Professional | AS · PA/NP assist | $85.11 | $109.65 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,698.24 Typical High $2,290.87 | Facility | None | $812.83 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $851.14 Typical High $1,230.27 | Professional | None | $588.84 | $851.14 | $1,230.27 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,122.02 | Professional | None | $588.84 | $758.58 | $1,122.02 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,148.15 | Professional | None | $616.60 | $758.58 | $1,148.15 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $1,023.29 | Professional | None | $524.81 | $758.58 | $1,023.29 |
12 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 $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $316.23 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $125.89 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $478.63 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $446.68 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $363.08 | $380.19 | $380.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $144.54 | $154.88 | $154.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $537.03 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $72.44 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $501.19 | $537.03 | $537.03 |
Where Maine sits
The same service costs 4.6 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 $6,475DE $1,401
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.