How much rates vary
Facilitymedian $6,310 · 10th to 90th $813 to $17,783Professionalmedian $4,074 · 10th to 90th $1,549 to $8,128
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $1,584.89 Median $1,584.89 Typical High $14,454.40 | Facility | None | $1,584.89 | $1,584.89 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $14,791.08 | Professional | None | $1,584.89 | $1,584.89 | $14,791.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $18,620.87 | Facility | None | $6,309.57 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $4,786.30 Typical High $8,511.38 | Professional | None | $1,548.82 | $4,786.30 | $8,511.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $2,951.21 Typical High $5,370.32 | Professional | 62 · Two surgeons | $977.24 | $2,951.21 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $758.58 Typical High $1,380.38 | Professional | 80 · Assistant surgeon | $245.47 | $758.58 | $1,380.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $660.69 Typical High $1,202.26 | Professional | AS · PA/NP assist | $218.78 | $660.69 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,235.94 Typical High $4,897.79 | Facility | None | $812.83 | $3,235.94 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,691.53 Typical High $5,011.87 | Professional | None | $1,698.24 | $2,691.53 | $5,011.87 |
DeanCare Setting Facility Modifier None Typical Low $1,445.44 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,445.44 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,187.76 Median $3,311.31 Typical High $4,365.16 | Professional | None | $2,187.76 | $3,311.31 | $4,365.16 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $4,073.80 Typical High $8,709.64 | Professional | None | $1,513.56 | $4,073.80 | $8,709.64 |
Network Health Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,630.27 | Facility | None | $1,862.09 | $2,089.30 | $2,630.27 |
Network Health Setting Professional Modifier None Typical Low $1,819.70 Median $3,090.30 Typical High $4,265.80 | Professional | None | $1,819.70 | $3,090.30 | $4,265.80 |
Prevea360 Setting Facility Modifier None Typical Low $1,148.15 Median $1,513.56 Typical High $2,754.23 | Facility | None | $1,148.15 | $1,513.56 | $2,754.23 |
Quartz Setting Professional Modifier None Typical Low $1,380.38 Median $3,162.28 Typical High $5,370.32 | Professional | None | $1,380.38 | $3,162.28 | $5,370.32 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $4,073.80 | Professional | None | $1,698.24 | $1,698.24 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
Security Health Setting Professional Modifier None Typical Low $3,235.94 Median $6,456.54 Typical High $7,413.10 | Professional | None | $3,235.94 | $6,456.54 | $7,413.10 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $3,801.89 Typical High $6,165.95 | Professional | None | $1,258.93 | $3,801.89 | $6,165.95 |
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 $794.33 Median $794.33 Typical High $7,413.10 | Professional | 52 · Reduced service | $794.33 | $794.33 | $7,413.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $2,951.21 | Professional | 53 · Discontinued | $316.23 | $316.23 | $2,951.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,202.26 Typical High $10,964.78 | Professional | 54 · Surgery only | $1,202.26 | $1,202.26 | $10,964.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $239.88 Typical High $2,238.72 | Professional | 55 · Aftercare only | $239.88 | $239.88 | $2,238.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $1,479.11 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $1,479.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,122.02 Typical High $10,232.93 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,122.02 | $10,232.93 |
Where Wisconsin sits
The same service costs 14.4 times more in Maine than in Washington. 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
ME $28,777WA $2,000
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.