How much rates vary
Facilitymedian $3,890 · 10th to 90th $2,512 to $7,079Professionalmedian $1,259 · 10th to 90th $912 to $2,239
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 $912.01 Median $1,023.29 Typical High $1,023.29 | Professional | None | $912.01 | $1,023.29 | $1,023.29 |
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 $1,122.02 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,584.89 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,344.23 Typical High $3,311.31 | Professional | 50 · Both sides | $1,548.82 | $2,344.23 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,000.00 Typical High $1,412.54 | Professional | 62 · Two surgeons | $645.65 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $251.19 Typical High $354.81 | Professional | 80 · Assistant surgeon | $165.96 | $251.19 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $218.78 Typical High $309.03 | Professional | AS · PA/NP assist | $144.54 | $218.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $3,162.28 Typical High $3,981.07 | Facility | None | $630.96 | $3,162.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,202.26 | $2,511.89 |
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 $831.76 Median $1,230.27 Typical High $2,187.76 | Professional | None | $831.76 | $1,230.27 | $2,187.76 |
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 $1,023.29 Median $1,230.27 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,230.27 | $2,187.76 |
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 $457.09 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $457.09 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $181.97 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $676.08 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $138.04 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $91.20 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $630.96 | $724.44 | $724.44 |
Where New Hampshire sits
The same service costs 5.0 times more in Alabama than in Kentucky. 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 $11,256KY $2,261
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.