How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $11,220Professionalmedian $1,445 · 10th to 90th $1,175 to $2,291
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 $1,348.96 Median $1,348.96 Typical High $1,380.38 | Facility | None | $1,348.96 | $1,348.96 | $1,380.38 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,348.96 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $16,218.10 | Facility | None | $5,888.44 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $912.01 Typical High $1,230.27 | Professional | 62 · Two surgeons | $741.31 | $912.01 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $234.42 Typical High $309.03 | Professional | 80 · Assistant surgeon | $186.21 | $234.42 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $204.17 Typical High $269.15 | Professional | AS · PA/NP assist | $162.18 | $204.17 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $2,041.74 | Facility | None | $1,096.48 | $1,318.26 | $2,041.74 |
CareSource Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,778.28 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,344.23 | Facility | None | $34.67 | $691.83 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $7,244.36 | Professional | None | $1,318.26 | $1,995.26 | $7,244.36 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,230.27 | $1,778.28 | $2,570.40 |
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 $676.08 Median $676.08 Typical High $758.58 | Professional | 52 · Reduced service | $676.08 | $676.08 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $302.00 | Professional | 53 · Discontinued | $269.15 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,023.29 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,023.29 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $204.17 Typical High $229.09 | Professional | 55 · Aftercare only | $199.53 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $151.36 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $954.99 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $954.99 | $1,047.13 |
Where Kentucky sits
The same service costs 13.5 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 $28,253WA $2,096
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.