How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $7,413Professionalmedian $2,042 · 10th to 90th $1,318 to $3,236
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 $1,513.56 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,513.56 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,513.56 Typical High $3,162.28 | Professional | None | $1,479.11 | $1,513.56 | $3,162.28 |
Ambetter Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,041.74 Typical High $9,772.37 | Facility | None | $707.95 | $2,041.74 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,230.27 | $2,089.30 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $3,467.37 Typical High $4,677.35 | Professional | 50 · Both sides | $2,290.87 | $3,467.37 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,445.44 Typical High $1,995.26 | Professional | 62 · Two surgeons | $954.99 | $1,445.44 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $380.19 Typical High $512.86 | Professional | 80 · Assistant surgeon | $234.42 | $380.19 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $316.23 Typical High $446.68 | Professional | AS · PA/NP assist | $208.93 | $316.23 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,884.03 Typical High $4,570.88 | Professional | None | $1,584.89 | $2,884.03 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $3,981.07 | Professional | None | $1,380.38 | $1,621.81 | $3,981.07 |
Oscar Health Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,344.23 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $4,570.88 | Professional | None | $1,445.44 | $2,290.87 | $4,570.88 |
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 $741.31 Median $758.58 Typical High $933.25 | Professional | 52 · Reduced service | $741.31 | $758.58 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $302.00 Typical High $371.54 | Professional | 53 · Discontinued | $295.12 | $302.00 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $151.36 Typical High $186.21 | Professional | 56 · Pre-op care only | $147.91 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,071.52 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,071.52 | $1,288.25 |
Where Georgia sits
The same service costs 7.5 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 $16,075MD $2,147
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.