How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,259 to $12,303Professionalmedian $1,585 · 10th to 90th $1,072 to $2,884
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 $1,258.93 Median $1,380.38 Typical High $9,772.37 | Facility | None | $1,258.93 | $1,380.38 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,258.93 | $2,290.87 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $933.25 Typical High $3,235.94 | Professional | None | $120.23 | $933.25 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $11,220.18 Typical High $20,892.96 | Facility | None | $8,912.51 | $11,220.18 | $20,892.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $2,884.03 | Professional | None | $1,318.26 | $2,041.74 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $3,019.95 Typical High $4,365.16 | Professional | 50 · Both sides | $1,995.26 | $3,019.95 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,258.93 Typical High $1,819.70 | Professional | 62 · Two surgeons | $831.76 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $323.59 Typical High $467.74 | Professional | 80 · Assistant surgeon | $208.93 | $323.59 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $281.84 Typical High $407.38 | Professional | AS · PA/NP assist | $186.21 | $281.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $6,456.54 Typical High $8,912.51 | Facility | None | $933.25 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,318.26 | $1,584.89 | $3,235.94 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $9,120.11 | Facility | None | $2,691.53 | $4,677.35 | $9,120.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,071.52 | $1,584.89 | $3,090.30 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $9,120.11 | Facility | None | $2,691.53 | $4,786.30 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,258.93 | $1,548.82 | $2,691.53 |
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 |
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 $537.03 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $537.03 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $213.80 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $812.83 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $162.18 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $107.15 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $758.58 | $870.96 | $870.96 |
Where New Hampshire sits
The same service costs 4.2 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 $14,362MT $3,396
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.