How much rates vary
Facilitymedian $3,236 · 10th to 90th $2,188 to $6,310Professionalmedian $1,202 · 10th to 90th $871 to $2,188
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 $3,388.44 Typical High $14,791.08 | Facility | None | $2,398.83 | $3,388.44 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $933.25 | Professional | None | $812.83 | $933.25 | $933.25 |
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 $1,023.29 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,584.89 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,344.23 Typical High $3,311.31 | Professional | 50 · Both sides | $1,548.82 | $2,344.23 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,000.00 Typical High $1,380.38 | Professional | 62 · Two surgeons | $645.65 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $251.19 Typical High $354.81 | Professional | 80 · Assistant surgeon | $165.96 | $251.19 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $218.78 Typical High $309.03 | Professional | AS · PA/NP assist | $144.54 | $218.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,162.28 Typical High $3,981.07 | Facility | None | $812.83 | $3,162.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,454.71 | Professional | None | $1,023.29 | $1,202.26 | $2,454.71 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $2,454.71 | Professional | None | $831.76 | $1,230.27 | $2,454.71 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,122.02 Typical High $2,041.74 | Professional | None | $912.01 | $1,122.02 | $2,041.74 |
Well Sense Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
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 $416.87 Median $467.74 Typical High $467.74 | Professional | 52 · Reduced service | $416.87 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $616.60 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $83.18 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $575.44 | $645.65 | $645.65 |
Where New Hampshire sits
The same service costs 3.1 times more in Wisconsin than in Maryland. 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
WI $8,115MD $2,591
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.