How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,233Professionalmedian $2,138 · 10th to 90th $1,413 to $5,754
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 $1,621.81 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,621.81 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,412.54 | $1,621.81 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,479.11 | $2,041.74 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,187.76 Median $3,090.30 Typical High $4,168.69 | Professional | 50 · Both sides | $2,187.76 | $3,090.30 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,288.25 Typical High $1,778.28 | Professional | 62 · Two surgeons | $933.25 | $1,288.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $331.13 Typical High $446.68 | Professional | 80 · Assistant surgeon | $234.42 | $331.13 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $288.40 Typical High $389.05 | Professional | AS · PA/NP assist | $204.17 | $288.40 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,348.96 | $1,778.28 |
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 $1,258.93 Median $1,698.24 Typical High $3,801.89 | Professional | None | $1,258.93 | $1,698.24 | $3,801.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $10,964.78 | Facility | None | $54.95 | $1,380.38 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $3,548.13 Typical High $10,471.29 | Professional | None | $1,905.46 | $3,548.13 | $10,471.29 |
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 $1,479.11 Median $2,398.83 Typical High $4,073.80 | Professional | None | $1,479.11 | $2,398.83 | $4,073.80 |
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 $707.95 Median $812.83 Typical High $851.14 | Professional | 52 · Reduced service | $707.95 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $323.59 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $245.47 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $162.18 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,148.15 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $1,148.15 | $1,202.26 |
Where Missouri 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.