How much rates vary
Facilitymedian $6,026 · 10th to 90th $2,692 to $11,220Professionalmedian $832 · 10th to 90th $589 to $1,514
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 $549.54 Median $630.96 Typical High $630.96 | Professional | None | $549.54 | $630.96 | $630.96 |
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 $691.83 Median $1,071.52 Typical High $1,479.11 | Professional | None | $691.83 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,621.81 Typical High $2,238.72 | Professional | 50 · Both sides | $1,047.13 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $169.82 Typical High $239.88 | Professional | 80 · Assistant surgeon | $112.20 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $151.36 Typical High $208.93 | Professional | AS · PA/NP assist | $97.72 | $151.36 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $6,456.54 Typical High $8,912.51 | Facility | None | $660.69 | $6,456.54 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,659.59 | Professional | None | $707.95 | $812.83 | $1,659.59 |
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 $562.34 Median $831.76 Typical High $1,621.81 | Professional | None | $562.34 | $831.76 | $1,621.81 |
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 $616.60 Median $758.58 Typical High $1,380.38 | Professional | None | $616.60 | $758.58 | $1,380.38 |
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 $269.15 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $269.15 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $109.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $467.74 Typical High $467.74 | Professional | 54 · Surgery only | $407.38 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $93.33 Typical High $93.33 | Professional | 55 · Aftercare only | $81.28 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $54.95 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $436.52 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $380.19 | $436.52 | $436.52 |
Where New Hampshire sits
The same service costs 7.9 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 $13,941MT $1,762
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.