How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,913Professionalmedian $1,549 · 10th to 90th $1,175 to $4,467
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 $1,348.96 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,348.96 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $3,890.45 Typical High $10,471.29 | Facility | None | $1,513.56 | $3,890.45 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,445.44 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,187.76 Typical High $3,467.37 | Professional | 50 · Both sides | $1,862.09 | $2,187.76 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $912.01 Typical High $1,445.44 | Professional | 62 · Two surgeons | $776.25 | $912.01 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $323.59 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,096.48 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $3,162.28 | Professional | None | $1,071.52 | $1,445.44 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $7,943.28 | Facility | None | $54.95 | $1,230.27 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $2,951.21 Typical High $10,232.93 | Professional | None | $1,584.89 | $2,951.21 | $10,232.93 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,258.93 | $1,995.26 | $3,388.44 |
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 $588.84 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $269.15 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,023.29 Typical High $1,047.13 | Professional | 54 · Surgery only | $870.96 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $204.17 Typical High $208.93 | Professional | 55 · Aftercare only | $173.78 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $134.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $954.99 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $812.83 | $954.99 | $977.24 |
Where Missouri 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.