How much rates vary
Facilitymedian $3,467 · 10th to 90th $501 to $11,749Professionalmedian $1,349 · 10th to 90th $112 to $2,138
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 $1,479.11 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,479.11 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $10,232.93 | Professional | None | $1,479.11 | $1,479.11 | $10,232.93 |
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 $1,202.26 Median $1,412.54 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,412.54 | $2,398.83 |
CareSource Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Facility | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $1,318.26 Median $1,659.59 Typical High $2,951.21 | Professional | None | $1,318.26 | $1,659.59 | $2,951.21 |
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 $1,318.26 Median $1,659.59 Typical High $3,162.28 | Professional | None | $1,318.26 | $1,659.59 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $1,174.90 Typical High $1,621.81 | Professional | None | $97.72 | $1,174.90 | $1,621.81 |
SummaCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,380.38 | $2,398.83 |
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 $1,412.54 Median $1,862.09 Typical High $3,981.07 | Professional | None | $1,412.54 | $1,862.09 | $3,981.07 |
10 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 $741.31 Typical High $2,137.96 | Professional | 52 · Reduced service | $741.31 | $741.31 | $2,137.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $870.96 | Professional | 53 · Discontinued | $295.12 | $295.12 | $870.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $3,235.94 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $3,235.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $645.65 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $645.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $147.91 Typical High $426.58 | Professional | 56 · Pre-op care only | $147.91 | $147.91 | $426.58 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $3,019.95 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,137.96 Typical High $3,548.13 | Professional | 50 · Both sides | $1,819.70 | $2,137.96 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $891.25 Typical High $1,513.56 | Professional | 62 · Two surgeons | $758.58 | $891.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $229.09 Typical High $398.11 | Professional | 80 · Assistant surgeon | $194.98 | $229.09 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $199.53 Typical High $331.13 | Professional | AS · PA/NP assist | $169.82 | $199.53 | $331.13 |
Where Ohio 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.