How much rates vary
Facilitymedian $1,445 · 10th to 90th $513 to $10,000Professionalmedian $1,096 · 10th to 90th $759 to $2,188
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 $891.25 Median $5,623.41 Typical High $10,000.00 | Facility | None | $891.25 | $5,623.41 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $2,344.23 | Professional | None | $870.96 | $933.25 | $2,344.23 |
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 $741.31 Median $1,096.48 Typical High $1,905.46 | Professional | None | $741.31 | $1,096.48 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $204.17 Typical High $302.00 | Professional | 80 · Assistant surgeon | $134.90 | $204.17 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $165.96 Typical High $269.15 | Professional | AS · PA/NP assist | $117.49 | $165.96 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,691.53 | Professional | None | $933.25 | $1,513.56 | $2,691.53 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $6,456.54 | Professional | None | $831.76 | $954.99 | $6,456.54 |
Oscar Health Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,380.38 | $1,513.56 | $1,513.56 |
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 $831.76 Median $1,348.96 Typical High $2,691.53 | Professional | None | $831.76 | $1,348.96 | $2,691.53 |
6 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 $436.52 Median $446.68 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $676.08 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $691.83 |
Where Georgia sits
The same service costs 18.7 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 $26,826MD $1,433
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.