How much rates vary
Facilitymedian $1,862 · 10th to 90th $468 to $14,791Professionalmedian $1,047 · 10th to 90th $501 to $2,291
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 $1,174.90 Median $1,548.82 Typical High $8,511.38 | Facility | None | $1,174.90 | $1,548.82 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,623.41 Median $9,772.37 Typical High $15,848.93 | Facility | None | $5,623.41 | $9,772.37 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $1,174.90 | Professional | None | $467.74 | $562.34 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $831.76 Typical High $1,778.28 | Professional | 50 · Both sides | $707.95 | $831.76 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $89.13 Typical High $186.21 | Professional | 80 · Assistant surgeon | $74.13 | $89.13 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $77.62 Typical High $165.96 | Professional | AS · PA/NP assist | $66.07 | $77.62 | $165.96 |
CareSource Setting Facility Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,698.24 | Facility | None | $912.01 | $1,071.52 | $1,698.24 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,479.11 Typical High $1,737.80 | Professional | None | $1,047.13 | $1,479.11 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,862.09 | Facility | None | $34.67 | $691.83 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $2,089.30 Typical High $5,011.87 | Professional | None | $1,096.48 | $2,089.30 | $5,011.87 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,380.38 | $1,819.70 | $2,344.23 |
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 $588.84 Median $645.65 Typical High $831.76 | Professional | 52 · Reduced service | $588.84 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $331.13 | Professional | 53 · Discontinued | $234.42 | $257.04 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $1,258.93 | Professional | 54 · Surgery only | $870.96 | $954.99 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $251.19 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $165.96 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $165.96 |
Where Kentucky 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.