How much rates vary
Facilitymedian $1,738 · 10th to 90th $457 to $8,913Professionalmedian $1,148 · 10th to 90th $851 to $2,042
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 $1,096.48 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,096.48 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,737.80 | Professional | None | $1,096.48 | $1,258.93 | $1,737.80 |
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 $831.76 Median $1,000.00 Typical High $1,445.44 | Professional | None | $831.76 | $1,000.00 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,230.27 Median $1,513.56 Typical High $2,137.96 | Professional | 50 · Both sides | $1,230.27 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $630.96 Typical High $1,023.29 | Professional | 62 · Two surgeons | $512.86 | $630.96 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $158.49 Typical High $229.09 | Professional | 80 · Assistant surgeon | $131.83 | $158.49 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $141.25 Typical High $199.53 | Professional | AS · PA/NP assist | $114.82 | $141.25 | $199.53 |
CareSource Setting Facility Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,584.89 | Facility | None | $831.76 | $1,000.00 | $1,584.89 |
CareSource Setting Professional Modifier None Typical Low $977.24 Median $1,380.38 Typical High $1,621.81 | Professional | None | $977.24 | $1,380.38 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,737.80 | Facility | None | $34.67 | $691.83 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,995.26 Typical High $6,606.93 | Professional | None | $1,023.29 | $1,995.26 | $6,606.93 |
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 $1,174.90 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,621.81 | $2,187.76 |
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 $549.54 Median $602.56 Typical High $776.25 | Professional | 52 · Reduced service | $549.54 | $602.56 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $239.88 Typical High $309.03 | Professional | 53 · Discontinued | $218.78 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $891.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $812.83 | $891.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $234.42 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $120.23 Typical High $154.88 | Professional | 56 · Pre-op care only | $109.65 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $831.76 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $758.58 | $831.76 | $1,071.52 |
Where Kentucky sits
The same service costs 8.5 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 $15,674MD $1,851
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.