How much rates vary
Facilitymedian $2,692 · 10th to 90th $813 to $7,943Professionalmedian $955 · 10th to 90th $741 to $1,413
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 $741.31 Median $954.99 Typical High $954.99 | Professional | None | $741.31 | $954.99 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,445.44 | Professional | None | $724.44 | $933.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,412.54 Typical High $2,137.96 | Professional | 50 · Both sides | $1,096.48 | $1,412.54 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $588.84 Typical High $912.01 | Professional | 62 · Two surgeons | $457.09 | $588.84 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $151.36 Typical High $229.09 | Professional | 80 · Assistant surgeon | $114.82 | $151.36 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $131.83 Typical High $199.53 | Professional | AS · PA/NP assist | $102.33 | $131.83 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,370.32 Typical High $8,709.64 | Facility | None | $812.83 | $5,370.32 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,548.82 | Professional | None | $851.14 | $1,071.52 | $1,548.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,318.26 | Professional | None | $741.31 | $933.25 | $1,318.26 |
Martin's Point Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $954.99 | Professional | None | $776.25 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,258.93 | Professional | None | $724.44 | $933.25 | $1,258.93 |
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 $389.05 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $588.84 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $549.54 | $676.08 | $676.08 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $446.68 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $177.83 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $676.08 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $630.96 | $676.08 | $676.08 |
Where Maine sits
The same service costs 6.0 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 $14,230MT $2,377
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.