How much rates vary
Facilitymedian $1,820 · 10th to 90th $1,318 to $3,890Professionalmedian $603 · 10th to 90th $407 to $1,047
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 $489.78 Median $1,819.70 Typical High $9,772.37 | Facility | None | $489.78 | $1,819.70 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | None | $389.05 | $489.78 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,737.80 Typical High $3,890.45 | Facility | None | $1,513.56 | $1,737.80 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,047.13 | Professional | None | $501.19 | $758.58 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $478.63 Typical High $660.69 | Professional | 62 · Two surgeons | $316.23 | $478.63 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $123.03 Typical High $169.82 | Professional | 80 · Assistant surgeon | $79.43 | $123.03 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $107.15 Typical High $147.91 | Professional | AS · PA/NP assist | $70.79 | $107.15 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,659.59 Typical High $2,290.87 | Facility | None | $537.03 | $1,659.59 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $1,122.02 | Professional | None | $489.78 | $602.56 | $1,122.02 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $4,265.80 | Facility | None | $1,698.24 | $1,949.84 | $4,265.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $1,148.15 | Professional | None | $407.38 | $575.44 | $1,148.15 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $4,265.80 | Facility | None | $1,698.24 | $2,089.30 | $4,265.80 |
United Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $891.25 | Professional | None | $380.19 | $489.78 | $891.25 |
Well Sense Setting Facility Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Facility | None | $676.08 | $676.08 | $676.08 |
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 $194.98 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $194.98 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $77.62 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $288.40 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $57.54 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.90 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $269.15 | $346.74 | $346.74 |
Where New Hampshire sits
The same service costs 4.0 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 $4,866MT $1,221
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.