How much rates vary
Facilitymedian $2,692 · 10th to 90th $1,096 to $7,943Professionalmedian $1,096 · 10th to 90th $851 to $1,698
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 $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,621.81 | Professional | None | $870.96 | $1,096.48 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,698.24 | Professional | None | $851.14 | $1,122.02 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,659.59 Typical High $2,511.89 | Professional | 50 · Both sides | $1,288.25 | $1,659.59 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $707.95 Typical High $1,071.52 | Professional | 62 · Two surgeons | $537.03 | $707.95 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $269.15 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $154.88 Typical High $234.42 | Professional | AS · PA/NP assist | $120.23 | $154.88 | $234.42 |
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 $977.24 Median $1,230.27 Typical High $1,778.28 | Professional | None | $977.24 | $1,230.27 | $1,778.28 |
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 $831.76 Median $1,047.13 Typical High $1,584.89 | Professional | None | $831.76 | $1,047.13 | $1,584.89 |
Martin's Point Setting Facility Modifier None Typical Low $114,815.36 Median $114,815.36 Typical High $114,815.36 | Facility | None | $114,815.36 | $114,815.36 | $114,815.36 |
Martin's Point Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,621.81 | Professional | None | $912.01 | $1,096.48 | $1,621.81 |
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 $812.83 Median $1,047.13 Typical High $1,445.44 | Professional | None | $812.83 | $1,047.13 | $1,445.44 |
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 $436.52 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $177.83 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $660.69 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $131.83 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $616.60 | $758.58 | $758.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $524.81 | $549.54 | $549.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $208.93 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $812.83 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $154.88 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $104.71 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $758.58 |
Where Maine sits
The same service costs 5.5 times more in Colorado than in Hawaii. 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 $14,085HI $2,567
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.