How much rates vary
Facilitymedian $2,692 · 10th to 90th $537 to $11,220Professionalmedian $1,905 · 10th to 90th $1,445 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 $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 $1,584.89 Median $1,819.70 Typical High $3,981.07 | Professional | None | $1,584.89 | $1,819.70 | $3,981.07 |
Ambetter Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $1,445.44 Median $1,659.59 Typical High $3,090.30 | Professional | None | $1,445.44 | $1,659.59 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $263.03 Typical High $489.78 | Professional | 80 · Assistant surgeon | $229.09 | $263.03 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $426.58 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $426.58 |
BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,513.56 | $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 $1,445.44 Median $1,995.26 Typical High $4,365.16 | Professional | None | $1,445.44 | $1,995.26 | $4,365.16 |
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 $2,089.30 Median $3,715.35 Typical High $10,715.19 | Professional | None | $2,089.30 | $3,715.35 | $10,715.19 |
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 $1,698.24 Median $2,691.53 Typical High $4,570.88 | Professional | None | $1,698.24 | $2,691.53 | $4,570.88 |
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 $794.33 Median $912.01 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $363.08 Typical High $389.05 | Professional | 53 · Discontinued | $316.23 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,380.38 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,174.90 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $275.42 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $181.97 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $181.97 | $194.98 |
Where Missouri sits
The same service costs 24.1 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 $53,525MD $2,222
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.