How much rates vary
Facilitymedian $1,820 · 10th to 90th $1,122 to $6,166Professionalmedian $933 · 10th to 90th $631 to $1,660
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 $588.84 Median $676.08 Typical High $691.83 | Professional | None | $588.84 | $676.08 | $691.83 |
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 $707.95 Median $1,202.26 Typical High $1,659.59 | Professional | None | $707.95 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,202.26 Median $1,819.70 Typical High $2,511.89 | Professional | 50 · Both sides | $1,202.26 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $758.58 Typical High $1,047.13 | Professional | 62 · Two surgeons | $501.19 | $758.58 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $194.98 Typical High $269.15 | Professional | 80 · Assistant surgeon | $125.89 | $194.98 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $169.82 Typical High $234.42 | Professional | AS · PA/NP assist | $112.20 | $169.82 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,398.83 Typical High $3,019.95 | Facility | None | $660.69 | $2,398.83 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,862.09 | Professional | None | $758.58 | $912.01 | $1,862.09 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $3,090.30 | Facility | None | $1,174.90 | $1,288.25 | $3,090.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $954.99 Typical High $1,819.70 | Professional | None | $645.65 | $954.99 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,122.02 | $1,258.93 | $3,090.30 |
United Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,548.82 | Professional | None | $575.44 | $831.76 | $1,548.82 |
Well Sense Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
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 $309.03 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $93.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $63.10 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $436.52 | $478.63 | $478.63 |
Where New Hampshire 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.