How much rates vary
Facilitymedian $6,166 · 10th to 90th $2,042 to $12,023Professionalmedian $1,318 · 10th to 90th $955 to $2,344
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 $977.24 Median $2,041.74 Typical High $11,481.54 | Facility | None | $977.24 | $2,041.74 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $1,819.70 | Professional | None | $870.96 | $977.24 | $1,819.70 |
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 $1,318.26 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,698.24 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,570.40 Typical High $3,548.13 | Professional | 50 · Both sides | $1,659.59 | $2,570.40 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $1,071.52 Typical High $1,479.11 | Professional | 62 · Two surgeons | $707.95 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $275.42 Typical High $380.19 | Professional | 80 · Assistant surgeon | $177.83 | $275.42 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $239.88 Typical High $331.13 | Professional | AS · PA/NP assist | $154.88 | $239.88 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $8,511.38 Typical High $11,481.54 | Facility | None | $660.69 | $8,511.38 | $11,481.54 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,288.25 | $2,691.53 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $3,890.45 Typical High $8,511.38 | Facility | None | $2,691.53 | $3,890.45 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $2,630.27 | Professional | None | $912.01 | $1,348.96 | $2,630.27 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,511.38 | Facility | None | $2,691.53 | $4,786.30 | $8,511.38 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,258.93 | $2,187.76 |
Well Sense Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
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 $436.52 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $128.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $691.83 | $691.83 |
Where New Hampshire 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.