How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $1,000 · 10th to 90th $759 to $2,399
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 $1,698.24 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $2,511.89 | Professional | None | $812.83 | $954.99 | $2,511.89 |
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 $758.58 Median $870.96 Typical High $1,621.81 | Professional | None | $758.58 | $870.96 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $138.04 Typical High $257.04 | Professional | 80 · Assistant surgeon | $120.23 | $138.04 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $123.03 Typical High $223.87 | Professional | AS · PA/NP assist | $104.71 | $123.03 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,071.52 | Professional | None | $741.31 | $794.33 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $1,047.13 Typical High $2,290.87 | Professional | None | $758.58 | $1,047.13 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $9,772.37 | Facility | None | $54.95 | $1,230.27 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $1,949.84 Typical High $5,623.41 | Professional | None | $1,096.48 | $1,949.84 | $5,623.41 |
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 $891.25 Median $1,380.38 Typical High $2,398.83 | Professional | None | $891.25 | $1,380.38 | $2,398.83 |
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 $407.38 Median $478.63 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $190.55 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $707.95 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $707.95 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $141.25 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $141.25 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $95.50 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $660.69 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $575.44 | $660.69 | $707.95 |
Where Missouri 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.