How much rates vary
Facilitymedian $5,248 · 10th to 90th $513 to $18,621Professionalmedian $1,175 · 10th to 90th $891 to $1,950
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 $3,467.37 Median $7,943.28 Typical High $12,589.25 | Facility | None | $3,467.37 | $7,943.28 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $3,235.94 Typical High $9,120.11 | Professional | None | $1,258.93 | $3,235.94 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $9,549.93 Typical High $22,387.21 | Facility | None | $1,174.90 | $9,549.93 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,174.90 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,778.28 Typical High $2,754.23 | Professional | 50 · Both sides | $1,479.11 | $1,778.28 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $186.21 Typical High $295.12 | Professional | 80 · Assistant surgeon | $158.49 | $186.21 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $165.96 Typical High $257.04 | Professional | AS · PA/NP assist | $138.04 | $165.96 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $3,235.94 | Facility | None | $426.58 | $588.84 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,412.54 | $2,630.27 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $3,235.94 | Facility | None | $426.58 | $588.84 | $3,235.94 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,148.15 | $1,412.54 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,445.44 | Professional | None | $741.31 | $1,096.48 | $1,445.44 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,202.26 | $2,089.30 |
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 $1,202.26 Median $1,659.59 Typical High $3,388.44 | Professional | None | $1,202.26 | $1,659.59 | $3,388.44 |
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 $630.96 Median $630.96 Typical High $1,737.80 | Professional | 52 · Reduced service | $630.96 | $630.96 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $691.83 | Professional | 53 · Discontinued | $257.04 | $257.04 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $2,570.40 | Professional | 54 · Surgery only | $954.99 | $954.99 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $524.81 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $346.74 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $346.74 |
Where Ohio 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.