How much rates vary
Facilitymedian $1,445 · 10th to 90th $513 to $10,471Professionalmedian $1,585 · 10th to 90th $1,096 to $3,162
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 $1,318.26 Median $7,413.10 Typical High $12,302.69 | Facility | None | $1,318.26 | $7,413.10 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $3,467.37 | Professional | None | $1,288.25 | $1,318.26 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $12,882.50 | Facility | None | $954.99 | $2,818.38 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,754.23 | Professional | None | $1,071.52 | $1,584.89 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,949.84 Median $2,398.83 Typical High $3,630.78 | Professional | 50 · Both sides | $1,949.84 | $2,398.83 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $288.40 Typical High $446.68 | Professional | 80 · Assistant surgeon | $194.98 | $288.40 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $239.88 Typical High $389.05 | Professional | AS · PA/NP assist | $169.82 | $239.88 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,511.89 | Facility | None | $457.09 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,348.96 | $2,187.76 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $8,912.51 | Professional | None | $1,202.26 | $1,380.38 | $8,912.51 |
Oscar Health Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,041.74 | $2,238.72 | $2,238.72 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $3,890.45 | Professional | None | $1,230.27 | $1,949.84 | $3,890.45 |
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 $645.65 Median $660.69 Typical High $724.44 | Professional | 52 · Reduced service | $645.65 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $288.40 | Professional | 53 · Discontinued | $257.04 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $954.99 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $144.54 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $144.54 |
Where Georgia sits
The same service costs 15.0 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 $27,402MD $1,821
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.