How much rates vary
Facilitymedian $2,754 · 10th to 90th $2,138 to $8,913Professionalmedian $1,413 · 10th to 90th $1,096 to $2,138
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 Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,348.96 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,290.87 Typical High $3,162.28 | Professional | 50 · Both sides | $1,621.81 | $2,290.87 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $954.99 Typical High $1,348.96 | Professional | 62 · Two surgeons | $691.83 | $954.99 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $245.47 Typical High $338.84 | Professional | 80 · Assistant surgeon | $173.78 | $245.47 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $213.80 Typical High $295.12 | Professional | AS · PA/NP assist | $151.36 | $213.80 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $5,011.87 Typical High $7,079.46 | Facility | None | $2,137.96 | $5,011.87 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,412.54 | $2,137.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $8,912.51 | Facility | None | $2,137.96 | $2,691.53 | $8,912.51 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,445.44 | $2,041.74 |
Martin's Point Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,348.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $8,912.51 | Facility | None | $2,137.96 | $2,691.53 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,445.44 | $1,949.84 |
12 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 $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $602.56 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $239.88 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $120.23 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $933.25 | $933.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $263.03 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $977.24 | $1,000.00 | $1,000.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $194.98 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $912.01 | $933.25 | $933.25 |
Where Maine sits
The same service costs 5.0 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 $14,731KY $2,968
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.