How much rates vary
Facilitymedian $3,981 · 10th to 90th $501 to $19,055Professionalmedian $1,380 · 10th to 90th $135 to $2,138
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 $1,380.38 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,380.38 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $6,606.93 | Professional | None | $1,380.38 | $1,380.38 | $6,606.93 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $1,819.70 | Professional | None | $245.47 | $245.47 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $9,549.93 Typical High $22,908.68 | Facility | None | $1,148.15 | $9,549.93 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,412.54 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,698.24 | $3,019.95 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,288.25 | $1,698.24 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,258.93 Typical High $1,905.46 | Professional | None | $123.03 | $1,258.93 | $1,905.46 |
SummaCare Setting Professional Modifier None Typical Low $1,348.96 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,412.54 | $2,691.53 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $3,162.28 | Professional | None | $1,230.27 | $1,548.82 | $3,162.28 |
9 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 $691.83 Median $691.83 Typical High $2,884.03 | Professional | 52 · Reduced service | $691.83 | $691.83 | $2,884.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,148.15 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,148.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $4,365.16 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $4,365.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $870.96 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $870.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $575.44 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $575.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $4,073.80 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $891.25 Typical High $1,445.44 | Professional | 62 · Two surgeons | $724.44 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $380.19 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $199.53 Typical High $323.59 | Professional | AS · PA/NP assist | $162.18 | $199.53 | $323.59 |
Where Ohio 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.