How much rates vary
Facilitymedian $3,467 · 10th to 90th $501 to $11,749Professionalmedian $1,148 · 10th to 90th $741 to $1,820
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 $1,258.93 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,258.93 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $9,332.54 | Professional | None | $1,258.93 | $1,258.93 | $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 $977.24 Median $1,148.15 Typical High $1,905.46 | Professional | None | $977.24 | $1,148.15 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,737.80 Typical High $2,818.38 | Professional | 50 · Both sides | $1,479.11 | $1,737.80 | $2,818.38 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $1,096.48 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,380.38 | $2,630.27 |
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 $1,096.48 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,096.48 | $1,380.38 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $70.79 Median $1,023.29 Typical High $1,348.96 | Professional | None | $70.79 | $1,023.29 | $1,348.96 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,148.15 | $1,995.26 |
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 $1,202.26 Median $1,479.11 Typical High $3,311.31 | Professional | None | $1,202.26 | $1,479.11 | $3,311.31 |
9 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 $616.60 Median $616.60 Typical High $1,778.28 | Professional | 52 · Reduced service | $616.60 | $616.60 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $724.44 | Professional | 53 · Discontinued | $251.19 | $251.19 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $2,691.53 | Professional | 54 · Surgery only | $933.25 | $933.25 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $537.03 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $354.81 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $724.44 Typical High $1,202.26 | Professional | 62 · Two surgeons | $616.60 | $724.44 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $302.00 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $162.18 Typical High $263.03 | Professional | AS · PA/NP assist | $138.04 | $162.18 | $263.03 |
Where Ohio 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.