How much rates vary
Facilitymedian $2,884 · 10th to 90th $537 to $10,000Professionalmedian $1,445 · 10th to 90th $1,096 to $3,467
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 $2,398.83 Median $5,370.32 Typical High $8,317.64 | Facility | None | $2,398.83 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $4,570.88 | Professional | None | $1,202.26 | $1,380.38 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $2,290.87 | Professional | None | $1,071.52 | $1,258.93 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,862.09 Typical High $3,467.37 | Professional | 50 · Both sides | $1,621.81 | $1,862.09 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $199.53 Typical High $371.54 | Professional | 80 · Assistant surgeon | $173.78 | $199.53 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $173.78 Typical High $323.59 | Professional | AS · PA/NP assist | $151.36 | $173.78 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,548.82 | Professional | None | $1,071.52 | $1,148.15 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $3,235.94 | Facility | None | $489.78 | $691.83 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $3,311.31 | Professional | None | $1,096.48 | $1,513.56 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $9,120.11 | Facility | None | $54.95 | $1,230.27 | $9,120.11 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $8,128.31 | Professional | None | $1,584.89 | $2,818.38 | $8,128.31 |
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 $1,288.25 Median $2,041.74 Typical High $3,467.37 | Professional | None | $1,288.25 | $2,041.74 | $3,467.37 |
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 $602.56 Median $691.83 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $275.42 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,047.13 Typical High $1,122.02 | Professional | 54 · Surgery only | $912.01 | $1,047.13 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $208.93 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $138.04 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $138.04 | $147.91 |
Where Missouri 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.