How much rates vary
Facilitymedian $2,818 · 10th to 90th $537 to $11,220Professionalmedian $1,738 · 10th to 90th $1,318 to $3,981
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 $2,041.74 Median $5,623.41 Typical High $11,748.98 | Facility | None | $2,041.74 | $5,623.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $3,548.13 | Professional | None | $1,412.54 | $1,659.59 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $16,982.44 | Facility | None | $1,412.54 | $3,801.89 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,513.56 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $239.88 Typical High $446.68 | Professional | 80 · Assistant surgeon | $208.93 | $239.88 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $208.93 Typical High $389.05 | Professional | AS · PA/NP assist | $181.97 | $208.93 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,380.38 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $10,964.78 | Facility | None | $489.78 | $691.83 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $3,981.07 | Professional | None | $1,288.25 | $1,778.28 | $3,981.07 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $10,964.78 | Facility | None | $54.95 | $1,230.27 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $3,311.31 Typical High $9,549.93 | Professional | None | $1,905.46 | $3,311.31 | $9,549.93 |
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 $1,548.82 Median $2,398.83 Typical High $4,073.80 | Professional | None | $1,548.82 | $2,398.83 | $4,073.80 |
5 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 $707.95 Median $812.83 Typical High $870.96 | Professional | 52 · Reduced service | $707.95 | $812.83 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $331.13 Typical High $346.74 | Professional | 53 · Discontinued | $281.84 | $331.13 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,230.27 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,230.27 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $245.47 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $245.47 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $165.96 Typical High $173.78 | Professional | 56 · Pre-op care only | $141.25 | $165.96 | $173.78 |
Where Missouri sits
The same service costs 25.6 times more in Maine than in Maryland. 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 $53,236MD $2,076
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.