How much rates vary
Facilitymedian $3,162 · 10th to 90th $2,188 to $6,310Professionalmedian $891 · 10th to 90th $646 to $1,660
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 $2,754.23 Typical High $11,481.54 | Facility | None | $2,398.83 | $2,754.23 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $758.58 | Professional | None | $660.69 | $758.58 | $758.58 |
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 $776.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $776.25 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,698.24 Typical High $2,398.83 | Professional | 50 · Both sides | $1,096.48 | $1,698.24 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $707.95 Typical High $1,023.29 | Professional | 62 · Two surgeons | $457.09 | $707.95 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $177.83 Typical High $257.04 | Professional | 80 · Assistant surgeon | $117.49 | $177.83 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $158.49 Typical High $223.87 | Professional | AS · PA/NP assist | $102.33 | $158.49 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $2,884.03 Typical High $3,981.07 | Facility | None | $660.69 | $2,884.03 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,819.70 | Professional | None | $741.31 | $891.25 | $1,819.70 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,187.76 Median $2,511.89 Typical High $4,677.35 | Facility | None | $2,187.76 | $2,511.89 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $588.84 Median $891.25 Typical High $1,737.80 | Professional | None | $588.84 | $891.25 | $1,737.80 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $3,162.28 Typical High $4,677.35 | Facility | None | $2,187.76 | $3,162.28 | $4,677.35 |
United Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,621.81 | Professional | None | $741.31 | $912.01 | $1,621.81 |
Well Sense 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 |
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 $331.13 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $331.13 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $489.78 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $97.72 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $66.07 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $457.09 | $524.81 | $524.81 |
Where New Hampshire sits
The same service costs 4.2 times more in Wisconsin 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
WI $7,788MT $1,867
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.