How much rates vary
Facilitymedian $3,467 · 10th to 90th $501 to $11,749Professionalmedian $1,230 · 10th to 90th $112 to $2,042
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 $10,232.93 Typical High $13,803.84 | Facility | None | $1,412.54 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $9,332.54 | Professional | None | $1,412.54 | $1,412.54 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $6,025.60 Typical High $12,589.25 | Facility | None | $1,071.52 | $6,025.60 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,230.27 | $2,089.30 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $1,258.93 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,584.89 | $3,090.30 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,584.89 | $3,090.30 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $1,122.02 Typical High $1,548.82 | Professional | None | $97.72 | $1,122.02 | $1,548.82 |
SummaCare Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,318.26 | $2,290.87 |
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 $1,318.26 Median $1,737.80 Typical High $3,801.89 | Professional | None | $1,318.26 | $1,737.80 | $3,801.89 |
10 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 $707.95 Median $707.95 Typical High $1,995.26 | Professional | 52 · Reduced service | $707.95 | $707.95 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $812.83 | Professional | 53 · Discontinued | $281.84 | $281.84 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $602.56 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $407.38 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $1,862.09 Typical High $3,090.30 | Professional | 50 · Both sides | $1,548.82 | $1,862.09 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $794.33 Typical High $1,318.26 | Professional | 62 · Two surgeons | $645.65 | $794.33 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $204.17 Typical High $354.81 | Professional | 80 · Assistant surgeon | $165.96 | $204.17 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $173.78 Typical High $295.12 | Professional | AS · PA/NP assist | $144.54 | $173.78 | $295.12 |
Where Ohio 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.