How much rates vary
Facilitymedian $3,311 · 10th to 90th $1,698 to $6,310Professionalmedian $1,047 · 10th to 90th $631 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 $630.96 Median $1,148.15 Typical High $14,791.08 | Facility | None | $630.96 | $1,148.15 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $758.58 | Professional | None | $602.56 | $630.96 | $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 $676.08 Median $1,148.15 Typical High $1,513.56 | Professional | None | $676.08 | $1,148.15 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,584.89 Typical High $2,137.96 | Professional | 50 · Both sides | $954.99 | $1,584.89 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $676.08 Typical High $891.25 | Professional | 62 · Two surgeons | $398.11 | $676.08 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $169.82 Typical High $229.09 | Professional | 80 · Assistant surgeon | $102.33 | $169.82 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $147.91 Typical High $199.53 | Professional | AS · PA/NP assist | $89.13 | $147.91 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $3,311.31 Typical High $4,897.79 | Facility | None | $1,698.24 | $3,311.31 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $1,659.59 | Professional | None | $691.83 | $1,174.90 | $1,659.59 |
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 $676.08 Median $933.25 Typical High $1,737.80 | Professional | None | $676.08 | $933.25 | $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 $660.69 Median $870.96 Typical High $1,737.80 | Professional | None | $660.69 | $870.96 | $1,737.80 |
Well Sense Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
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 $302.00 Median $316.23 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $125.89 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $478.63 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $95.50 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $446.68 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $446.68 | $524.81 |
Where New Hampshire sits
The same service costs 3.8 times more in Oklahoma 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
OK $7,804MT $2,047
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.