How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $1,995 · 10th to 90th $1,349 to $4,571
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 $1,659.59 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,659.59 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,412.54 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,412.54 | $2,511.89 |
Ambetter Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,995.26 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,412.54 | $2,041.74 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,288.25 Typical High $1,698.24 | Professional | 62 · Two surgeons | $891.25 | $1,288.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $331.13 Typical High $426.58 | Professional | 80 · Assistant surgeon | $223.87 | $331.13 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $288.40 Typical High $380.19 | Professional | AS · PA/NP assist | $199.53 | $288.40 | $380.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,479.11 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,621.81 Typical High $3,715.35 | Professional | None | $1,318.26 | $1,621.81 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $11,220.18 | Facility | None | $54.95 | $1,348.96 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $2,884.03 Typical High $12,022.64 | Professional | None | $1,584.89 | $2,884.03 | $12,022.64 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,445.44 | $2,041.74 | $2,951.21 |
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 $630.96 Median $707.95 Typical High $758.58 | Professional | 52 · Reduced service | $630.96 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $281.84 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $281.84 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,122.02 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $208.93 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $141.25 Typical High $151.36 | Professional | 56 · Pre-op care only | $125.89 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $1,047.13 |
Where Missouri 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.