How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,000 to $8,128Professionalmedian $1,230 · 10th to 90th $933 to $1,862
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 $1,000.00 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,000.00 | $1,230.27 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,862.09 | Professional | None | $954.99 | $1,258.93 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,862.09 Typical High $2,818.38 | Professional | 50 · Both sides | $1,445.44 | $1,862.09 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $776.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $602.56 | $776.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $208.93 Typical High $302.00 | Professional | 80 · Assistant surgeon | $151.36 | $208.93 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $173.78 Typical High $263.03 | Professional | AS · PA/NP assist | $134.90 | $173.78 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $5,495.41 Typical High $8,912.51 | Facility | None | $1,000.00 | $5,495.41 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,348.96 | $1,949.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,737.80 | Professional | None | $933.25 | $1,202.26 | $1,737.80 |
Martin's Point Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,148.15 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $1,621.81 | Professional | None | $912.01 | $1,202.26 | $1,621.81 |
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 $501.19 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $199.53 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $151.36 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $851.14 | $851.14 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $575.44 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $229.09 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $851.14 | $912.01 | $912.01 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $114.82 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $851.14 |
Where Maine sits
The same service costs 4.7 times more in Colorado than in Hawaii. 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 $14,231HI $3,050
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.