How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,698 to $10,233Professionalmedian $692 · 10th to 90th $427 to $1,288
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 $3,388.44 Typical High $14,791.08 | Facility | None | $2,398.83 | $3,388.44 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $707.95 | Professional | None | $446.68 | $588.84 | $707.95 |
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 $389.05 Median $645.65 Typical High $831.76 | Professional | None | $389.05 | $645.65 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $6,456.54 Typical High $8,912.51 | Facility | None | $812.83 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $1,737.80 | Professional | None | $562.34 | $891.25 | $1,737.80 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $6,165.95 | Facility | None | $1,698.24 | $1,949.84 | $6,165.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $457.09 Median $776.25 Typical High $1,584.89 | Professional | None | $457.09 | $776.25 | $1,584.89 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $6,165.95 | Facility | None | $1,698.24 | $2,089.30 | $6,165.95 |
United Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,445.44 | Professional | None | $524.81 | $812.83 | $1,445.44 |
Well Sense Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
10 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 $239.88 Median $275.42 Typical High $354.81 | Professional | 52 · Reduced service | $239.88 | $275.42 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $141.25 | Professional | 53 · Discontinued | $95.50 | $109.65 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $407.38 Typical High $524.81 | Professional | 54 · Surgery only | $354.81 | $407.38 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $81.28 Typical High $107.15 | Professional | 55 · Aftercare only | $70.79 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $70.79 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $380.19 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $331.13 | $380.19 | $489.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,202.26 Typical High $1,584.89 | Professional | 50 · Both sides | $794.33 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $501.19 Typical High $676.08 | Professional | 62 · Two surgeons | $331.13 | $501.19 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $128.82 Typical High $169.82 | Professional | 80 · Assistant surgeon | $83.18 | $128.82 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $74.13 Median $112.20 Typical High $147.91 | Professional | AS · PA/NP assist | $74.13 | $112.20 | $147.91 |
Where New Hampshire 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.