How much rates vary
Facilitymedian $6,310 · 10th to 90th $813 to $16,982Professionalmedian $3,467 · 10th to 90th $1,230 to $7,762
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 $1,258.93 Median $1,258.93 Typical High $14,454.40 | Facility | None | $1,258.93 | $1,258.93 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $11,481.54 | Professional | None | $1,122.02 | $1,258.93 | $11,481.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,309.57 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $3,890.45 Typical High $8,317.64 | Professional | None | $1,096.48 | $3,890.45 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $5,888.44 Typical High $12,022.64 | Professional | 50 · Both sides | $1,621.81 | $5,888.44 | $12,022.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $2,454.71 Typical High $5,011.87 | Professional | 62 · Two surgeons | $691.83 | $2,454.71 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $630.96 Typical High $1,288.25 | Professional | 80 · Assistant surgeon | $173.78 | $630.96 | $1,288.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $549.54 Typical High $1,122.02 | Professional | AS · PA/NP assist | $151.36 | $549.54 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,398.83 Typical High $3,715.35 | Facility | None | $812.83 | $2,398.83 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $3,019.95 Typical High $5,248.07 | Professional | None | $1,621.81 | $3,019.95 | $5,248.07 |
DeanCare Setting Facility Modifier None Typical Low $1,096.48 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,096.48 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $3,388.44 | Professional | None | $1,995.26 | $2,511.89 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $3,548.13 Typical High $5,623.41 | Professional | None | $1,230.27 | $3,548.13 | $5,623.41 |
Network Health Setting Facility Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,089.30 | Facility | None | $1,412.54 | $2,089.30 | $2,089.30 |
Network Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,380.38 | $2,398.83 | $3,311.31 |
Prevea360 Setting Facility Modifier None Typical Low $870.96 Median $1,202.26 Typical High $2,137.96 | Facility | None | $870.96 | $1,202.26 | $2,137.96 |
Quartz Setting Professional Modifier None Typical Low $1,023.29 Median $2,398.83 Typical High $4,466.84 | Professional | None | $1,023.29 | $2,398.83 | $4,466.84 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,621.81 | $2,238.72 |
Security Health Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Security Health Setting Professional Modifier None Typical Low $4,570.88 Median $6,165.95 Typical High $6,918.31 | Professional | None | $4,570.88 | $6,165.95 | $6,918.31 |
The Alliance Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $8,128.31 | Professional | None | $6,606.93 | $6,606.93 | $8,128.31 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $3,548.13 Typical High $5,495.41 | Professional | None | $1,148.15 | $3,548.13 | $5,495.41 |
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 $630.96 Median $630.96 Typical High $5,623.41 | Professional | 52 · Reduced service | $630.96 | $630.96 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $2,290.87 | Professional | 53 · Discontinued | $251.19 | $251.19 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $8,511.38 | Professional | 54 · Surgery only | $933.25 | $933.25 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $1,698.24 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $7,943.28 |
Where Wisconsin sits
The same service costs 9.1 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 $15,604MD $1,710
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.