How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,288 to $12,023Professionalmedian $1,072 · 10th to 90th $759 to $1,950
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 $831.76 Median $831.76 Typical High $11,481.54 | Facility | None | $831.76 | $831.76 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $891.25 | Professional | None | $724.44 | $831.76 | $891.25 |
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 $1,047.13 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,380.38 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $2,041.74 Typical High $2,884.03 | Professional | 50 · Both sides | $1,348.96 | $2,041.74 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $870.96 Typical High $1,230.27 | Professional | 62 · Two surgeons | $562.34 | $870.96 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $218.78 Typical High $309.03 | Professional | 80 · Assistant surgeon | $144.54 | $218.78 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $190.55 Typical High $269.15 | Professional | AS · PA/NP assist | $125.89 | $190.55 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $8,511.38 Typical High $11,748.98 | Facility | None | $660.69 | $8,511.38 | $11,748.98 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $2,137.96 | Professional | None | $891.25 | $1,071.52 | $2,137.96 |
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 $724.44 Median $1,096.48 Typical High $2,137.96 | Professional | None | $724.44 | $1,096.48 | $2,137.96 |
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 $831.76 Median $1,000.00 Typical High $1,778.28 | Professional | None | $831.76 | $1,000.00 | $1,778.28 |
Well Sense Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,090.30 | Facility | None | $3,090.30 | $3,090.30 | $3,090.30 |
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 $363.08 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $363.08 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $109.65 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $72.44 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $512.86 | $575.44 | $575.44 |
Where New Hampshire sits
The same service costs 6.1 times more in Colorado than in Montana. 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 $13,882MT $2,270
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.