How much rates vary
Facilitymedian $7,413 · 10th to 90th $513 to $36,308Professionalmedian $1,380 · 10th to 90th $112 to $2,188
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 $3,548.13 Median $10,232.93 Typical High $19,498.45 | Facility | None | $3,548.13 | $10,232.93 | $19,498.45 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $3,890.45 Typical High $12,022.64 | Professional | None | $1,513.56 | $3,890.45 | $12,022.64 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $19,054.61 Typical High $41,686.94 | Facility | None | $1,479.11 | $19,054.61 | $41,686.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,187.76 | Professional | None | $1,202.26 | $1,412.54 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $354.81 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $309.03 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $10,964.78 | Facility | None | $426.58 | $588.84 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,698.24 | $3,235.94 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $10,964.78 | Facility | None | $426.58 | $588.84 | $10,964.78 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,698.24 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $1,202.26 Typical High $1,621.81 | Professional | None | $97.72 | $1,202.26 | $1,621.81 |
SummaCare Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,412.54 | $2,454.71 |
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 $1,412.54 Median $1,995.26 Typical High $4,073.80 | Professional | None | $1,412.54 | $1,995.26 | $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 $758.58 Median $758.58 Typical High $2,041.74 | Professional | 52 · Reduced service | $758.58 | $758.58 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $812.83 | Professional | 53 · Discontinued | $302.00 | $302.00 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,122.02 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,122.02 | $1,122.02 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $223.87 Typical High $616.60 | Professional | 55 · Aftercare only | $223.87 | $223.87 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $407.38 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $407.38 |
Where Ohio 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.