How much rates vary
Facilitymedian $1,288 · 10th to 90th $468 to $11,220Professionalmedian $813 · 10th to 90th $631 to $1,585
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 $794.33 Median $1,071.52 Typical High $8,511.38 | Facility | None | $794.33 | $1,071.52 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,258.93 | Professional | None | $794.33 | $870.96 | $1,258.93 |
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 $630.96 Median $741.31 Typical High $933.25 | Professional | None | $630.96 | $741.31 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $120.23 Typical High $151.36 | Professional | 80 · Assistant surgeon | $102.33 | $120.23 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $131.83 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $131.83 |
CareSource Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $1,174.90 | Facility | None | $616.60 | $741.31 | $1,174.90 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,202.26 | Professional | None | $724.44 | $1,023.29 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,288.25 | Facility | None | $34.67 | $691.83 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,412.54 Typical High $3,467.37 | Professional | None | $741.31 | $1,412.54 | $3,467.37 |
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 $954.99 Median $1,258.93 Typical High $1,621.81 | Professional | None | $954.99 | $1,258.93 | $1,621.81 |
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 $398.11 Median $436.52 Typical High $575.44 | Professional | 52 · Reduced service | $398.11 | $436.52 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $229.09 | Professional | 53 · Discontinued | $158.49 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $660.69 Typical High $870.96 | Professional | 54 · Surgery only | $602.56 | $660.69 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $131.83 Typical High $173.78 | Professional | 55 · Aftercare only | $120.23 | $131.83 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $114.82 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $616.60 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $562.34 | $616.60 | $812.83 |
Where Kentucky 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.