How much rates vary
Facilitymedian $1,950 · 10th to 90th $457 to $8,913Professionalmedian $1,585 · 10th to 90th $1,148 to $2,630
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 $1,737.80 Typical High $1,778.28 | Facility | None | $1,348.96 | $1,737.80 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,348.96 | $1,513.56 | $2,137.96 |
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 $1,148.15 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,238.72 Typical High $2,818.38 | Professional | 50 · Both sides | $1,737.80 | $2,238.72 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $933.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $724.44 | $933.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $239.88 Typical High $302.00 | Professional | 80 · Assistant surgeon | $186.21 | $239.88 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $208.93 Typical High $263.03 | Professional | AS · PA/NP assist | $162.18 | $208.93 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,949.84 | Facility | None | $1,047.13 | $1,258.93 | $1,949.84 |
CareSource Setting Professional Modifier None Typical Low $1,230.27 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,698.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,187.76 | Facility | None | $34.67 | $512.86 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $2,570.40 Typical High $9,120.11 | Professional | None | $1,258.93 | $2,570.40 | $9,120.11 |
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 $1,621.81 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,621.81 | $2,089.30 | $2,818.38 |
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 $676.08 Median $758.58 Typical High $977.24 | Professional | 52 · Reduced service | $676.08 | $758.58 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $302.00 Typical High $389.05 | Professional | 53 · Discontinued | $269.15 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $229.09 Typical High $288.40 | Professional | 55 · Aftercare only | $199.53 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $151.36 Typical High $194.98 | Professional | 56 · Pre-op care only | $134.90 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,348.96 |
Where Kentucky 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.