How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,698 to $6,166Professionalmedian $617 · 10th to 90th $355 to $1,148
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 $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $691.83 | Professional | None | $416.87 | $549.54 | $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 $323.59 Median $549.54 Typical High $707.95 | Professional | None | $323.59 | $549.54 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,884.03 Typical High $3,981.07 | Facility | None | $575.44 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $776.25 Typical High $1,479.11 | Professional | None | $478.63 | $776.25 | $1,479.11 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $380.19 Median $691.83 Typical High $1,318.26 | Professional | None | $380.19 | $691.83 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $457.09 Median $812.83 Typical High $1,445.44 | Professional | None | $457.09 | $812.83 | $1,445.44 |
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 |
9 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 $218.78 Median $251.19 Typical High $346.74 | Professional | 52 · Reduced service | $218.78 | $251.19 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $138.04 | Professional | 53 · Discontinued | $87.10 | $100.00 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $380.19 Typical High $512.86 | Professional | 54 · Surgery only | $323.59 | $380.19 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $75.86 Typical High $102.33 | Professional | 55 · Aftercare only | $64.57 | $75.86 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $69.18 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $354.81 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $302.00 | $354.81 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $1,000.00 Typical High $1,348.96 | Professional | 50 · Both sides | $758.58 | $1,000.00 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $107.15 Typical High $144.54 | Professional | 80 · Assistant surgeon | $81.28 | $107.15 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $93.33 Typical High $125.89 | Professional | AS · PA/NP assist | $70.79 | $93.33 | $125.89 |
Where New Hampshire sits
The same service costs 4.4 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 $6,451MT $1,460
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.