How much rates vary
Facilitymedian $8,128 · 10th to 90th $2,884 to $12,589Professionalmedian $2,042 · 10th to 90th $1,259 to $3,236
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 $1,202.26 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,258.93 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,332.54 Median $10,471.29 Typical High $19,952.62 | Facility | None | $9,332.54 | $10,471.29 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,230.27 | $2,238.72 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,348.96 Typical High $1,819.70 | Professional | 62 · Two surgeons | $758.58 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $338.84 Typical High $457.09 | Professional | 80 · Assistant surgeon | $194.98 | $338.84 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $295.12 Typical High $398.11 | Professional | AS · PA/NP assist | $169.82 | $295.12 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $9,772.37 Typical High $12,302.69 | Facility | None | $630.96 | $9,772.37 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,348.96 | $2,290.87 | $3,235.94 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,884.03 Median $4,168.69 Typical High $10,964.78 | Facility | None | $2,884.03 | $4,168.69 | $10,964.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $3,388.44 | Professional | None | $1,288.25 | $1,778.28 | $3,388.44 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $5,754.40 Typical High $10,964.78 | Facility | None | $2,884.03 | $5,754.40 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,288.25 | $1,737.80 | $3,388.44 |
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 $602.56 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $602.56 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $125.89 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $1,023.29 |
Where New Hampshire sits
The same service costs 4.8 times more in Colorado than in Kentucky. 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 $16,795KY $3,466
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.