How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,000 to $6,026Professionalmedian $617 · 10th to 90th $427 to $933
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 $501.19 Median $660.69 Typical High $870.96 | Professional | None | $501.19 | $660.69 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $794.33 | Professional | None | $398.11 | $549.54 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $4,168.69 Typical High $6,606.93 | Facility | None | $1,000.00 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $933.25 | Professional | None | $524.81 | $794.33 | $933.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $1,202.26 | Professional | None | $457.09 | $691.83 | $1,202.26 |
Martin's Point Setting Professional Modifier None Typical Low $512.86 Median $707.95 Typical High $870.96 | Professional | None | $512.86 | $707.95 | $870.96 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $1,047.13 | Professional | None | $407.38 | $616.60 | $1,047.13 |
16 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 $257.04 Median $257.04 Typical High $389.05 | Professional | 52 · Reduced service | $257.04 | $257.04 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | 53 · Discontinued | $102.33 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $588.84 | Professional | 54 · Surgery only | $380.19 | $380.19 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $117.49 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $77.62 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $549.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $831.76 Typical High $1,174.90 | Professional | 50 · Both sides | $602.56 | $831.76 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $346.74 Typical High $489.78 | Professional | 62 · Two surgeons | $251.19 | $346.74 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $87.10 Typical High $125.89 | Professional | 80 · Assistant surgeon | $64.57 | $87.10 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $77.62 Typical High $109.65 | Professional | AS · PA/NP assist | $56.23 | $77.62 | $109.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $257.04 Typical High $389.05 | Professional | 52 · Reduced service | $257.04 | $257.04 | $389.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | 53 · Discontinued | $102.33 | $102.33 | $154.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $588.84 | Professional | 54 · Surgery only | $380.19 | $380.19 | $588.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $117.49 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $77.62 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $77.62 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $549.54 |
Where Maine sits
The same service costs 6.5 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 $9,949MT $1,532
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.