How much rates vary
Facilitymedian $1,778 · 10th to 90th $457 to $8,913Professionalmedian $1,349 · 10th to 90th $977 to $2,188
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 $1,122.02 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,122.02 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,122.02 | $1,479.11 | $2,344.23 |
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 $977.24 Median $1,258.93 Typical High $1,698.24 | Professional | None | $977.24 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,862.09 Typical High $2,511.89 | Professional | 50 · Both sides | $1,445.44 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $794.33 Typical High $1,071.52 | Professional | 62 · Two surgeons | $616.60 | $794.33 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $199.53 Typical High $269.15 | Professional | 80 · Assistant surgeon | $154.88 | $199.53 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $173.78 Typical High $234.42 | Professional | AS · PA/NP assist | $134.90 | $173.78 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,621.81 | Facility | None | $851.14 | $1,023.29 | $1,621.81 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,412.54 Typical High $1,659.59 | Professional | None | $912.01 | $1,412.54 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,778.28 | Facility | None | $34.67 | $691.83 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $2,137.96 Typical High $7,244.36 | Professional | None | $1,071.52 | $2,137.96 | $7,244.36 |
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 $1,318.26 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,318.26 | $1,698.24 | $2,290.87 |
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 $549.54 Median $630.96 Typical High $812.83 | Professional | 52 · Reduced service | $549.54 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $251.19 Typical High $323.59 | Professional | 53 · Discontinued | $223.87 | $251.19 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $1,202.26 | Professional | 54 · Surgery only | $831.76 | $933.25 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $190.55 Typical High $239.88 | Professional | 55 · Aftercare only | $165.96 | $190.55 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $162.18 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $1,122.02 |
Where Kentucky sits
The same service costs 8.2 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 $15,747MD $1,911
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.