How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,698 to $10,000Professionalmedian $724 · 10th to 90th $513 to $1,288
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 $489.78 Median $575.44 Typical High $575.44 | Professional | None | $489.78 | $575.44 | $575.44 |
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 $602.56 Median $933.25 Typical High $1,288.25 | Professional | None | $602.56 | $933.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $575.44 Typical High $812.83 | Professional | 62 · Two surgeons | $380.19 | $575.44 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $147.91 Typical High $204.17 | Professional | 80 · Assistant surgeon | $95.50 | $147.91 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $128.82 Typical High $181.97 | Professional | AS · PA/NP assist | $85.11 | $128.82 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $6,456.54 Typical High $8,912.51 | Facility | None | $575.44 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,445.44 | Professional | None | $602.56 | $707.95 | $1,445.44 |
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 $489.78 Median $741.31 Typical High $1,412.54 | Professional | None | $489.78 | $741.31 | $1,412.54 |
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 $588.84 Median $724.44 Typical High $1,202.26 | Professional | None | $588.84 | $724.44 | $1,202.26 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $245.47 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $363.08 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $48.98 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $338.84 | $398.11 | $398.11 |
Where New Hampshire sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.