How much rates vary
Facilitymedian $1,862 · 10th to 90th $457 to $8,913Professionalmedian $1,514 · 10th to 90th $1,072 to $2,570
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 $1,288.25 Median $1,318.26 Typical High $1,737.80 | Facility | None | $1,288.25 | $1,318.26 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,288.25 | $1,412.54 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $5,370.32 Typical High $10,715.19 | Facility | None | $3,162.28 | $5,370.32 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,445.44 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,137.96 Typical High $2,691.53 | Professional | 50 · Both sides | $1,621.81 | $2,137.96 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $912.01 Typical High $1,148.15 | Professional | 62 · Two surgeons | $676.08 | $912.01 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $229.09 Typical High $288.40 | Professional | 80 · Assistant surgeon | $173.78 | $229.09 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $199.53 Typical High $251.19 | Professional | AS · PA/NP assist | $151.36 | $199.53 | $251.19 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,862.09 | Facility | None | $1,000.00 | $1,202.26 | $1,862.09 |
CareSource Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,621.81 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,089.30 | Facility | None | $34.67 | $691.83 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $6,918.31 | Professional | None | $1,202.26 | $2,398.83 | $6,918.31 |
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 $1,412.54 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,949.84 | $2,630.27 |
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 $645.65 Median $707.95 Typical High $912.01 | Professional | 52 · Reduced service | $645.65 | $707.95 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $363.08 | Professional | 53 · Discontinued | $257.04 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,348.96 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $269.15 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $181.97 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $1,258.93 |
Where Kentucky 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.