How much rates vary
Facilitymedian $5,012 · 10th to 90th $513 to $18,621Professionalmedian $813 · 10th to 90th $603 to $1,349
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 $2,511.89 Median $8,511.38 Typical High $13,803.84 | Facility | None | $2,511.89 | $8,511.38 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $2,238.72 Typical High $9,332.54 | Professional | None | $870.96 | $2,238.72 | $9,332.54 |
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 $691.83 Median $812.83 Typical High $1,258.93 | Professional | None | $691.83 | $812.83 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $131.83 Typical High $208.93 | Professional | 80 · Assistant surgeon | $112.20 | $131.83 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $114.82 Typical High $177.83 | Professional | AS · PA/NP assist | $97.72 | $114.82 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,862.09 | Professional | None | $776.25 | $977.24 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,862.09 | Professional | None | $776.25 | $977.24 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $501.19 Median $758.58 Typical High $1,000.00 | Professional | None | $501.19 | $758.58 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,412.54 | Professional | None | $741.31 | $812.83 | $1,412.54 |
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 $831.76 Median $1,148.15 Typical High $2,398.83 | Professional | None | $831.76 | $1,148.15 | $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 $436.52 Median $436.52 Typical High $1,258.93 | Professional | 52 · Reduced service | $436.52 | $436.52 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $501.19 | Professional | 53 · Discontinued | $173.78 | $173.78 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $660.69 Typical High $1,905.46 | Professional | 54 · Surgery only | $660.69 | $660.69 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $131.83 Typical High $380.19 | Professional | 55 · Aftercare only | $131.83 | $131.83 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $251.19 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $616.60 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $616.60 | $616.60 | $1,778.28 |
Where Ohio 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.