How much rates vary
Facilitymedian $6,166 · 10th to 90th $2,138 to $11,220Professionalmedian $1,778 · 10th to 90th $1,202 to $3,162
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 $1,513.56 Median $2,137.96 Typical High $11,481.54 | Facility | None | $1,513.56 | $2,137.96 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,202.26 | $1,621.81 | $1,621.81 |
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 $1,698.24 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,698.24 | $2,187.76 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $3,311.31 Typical High $4,677.35 | Professional | 50 · Both sides | $2,344.23 | $3,311.31 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,380.38 Typical High $1,949.84 | Professional | 62 · Two surgeons | $977.24 | $1,380.38 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $346.74 Typical High $501.19 | Professional | 80 · Assistant surgeon | $245.47 | $346.74 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $309.03 Typical High $436.52 | Professional | AS · PA/NP assist | $218.78 | $309.03 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $7,079.46 Typical High $8,912.51 | Facility | None | $1,698.24 | $7,079.46 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $3,311.31 | Professional | None | $1,412.54 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $8,912.51 | Facility | None | $2,691.53 | $4,677.35 | $8,912.51 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,174.90 | $1,737.80 | $3,388.44 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,786.30 Typical High $8,912.51 | Facility | None | $2,691.53 | $4,786.30 | $8,912.51 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,584.89 | $2,884.03 |
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 $602.56 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $602.56 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $239.88 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $912.01 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $181.97 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $120.23 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $851.14 | $1,148.15 | $1,148.15 |
Where New Hampshire 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.