How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $7,413Professionalmedian $1,820 · 10th to 90th $1,259 to $3,090
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 $1,412.54 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,412.54 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,412.54 Typical High $3,019.95 | Professional | None | $1,380.38 | $1,412.54 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,041.74 Typical High $9,772.37 | Facility | None | $707.95 | $2,041.74 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $3,019.95 | Professional | None | $1,174.90 | $1,819.70 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $3,090.30 Typical High $4,570.88 | Professional | 50 · Both sides | $1,995.26 | $3,090.30 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,288.25 Typical High $1,949.84 | Professional | 62 · Two surgeons | $851.14 | $1,288.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $338.84 Typical High $489.78 | Professional | 80 · Assistant surgeon | $213.80 | $338.84 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $288.40 Typical High $426.58 | Professional | AS · PA/NP assist | $186.21 | $288.40 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,754.23 Typical High $4,265.80 | Professional | None | $1,479.11 | $2,754.23 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $3,801.89 | Professional | None | $1,318.26 | $1,445.44 | $3,801.89 |
Oscar Health Setting Professional Modifier None Typical Low $4,168.69 Median $4,168.69 Typical High $4,570.88 | Professional | None | $4,168.69 | $4,168.69 | $4,570.88 |
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 $1,348.96 Median $2,137.96 Typical High $4,365.16 | Professional | None | $1,348.96 | $2,137.96 | $4,365.16 |
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 $691.83 Median $707.95 Typical High $870.96 | Professional | 52 · Reduced service | $691.83 | $707.95 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $346.74 | Professional | 53 · Discontinued | $281.84 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,071.52 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,071.52 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $213.80 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $141.25 Typical High $173.78 | Professional | 56 · Pre-op care only | $138.04 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,000.00 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,000.00 | $1,202.26 |
Where Georgia sits
The same service costs 8.1 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 $15,945MD $1,975
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.