How much rates vary
Facilitymedian $6,761 · 10th to 90th $912 to $16,982Professionalmedian $3,631 · 10th to 90th $1,318 to $8,318
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 $1,318.26 Median $1,318.26 Typical High $14,454.40 | Facility | None | $1,318.26 | $1,318.26 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $11,481.54 | Professional | None | $1,318.26 | $1,318.26 | $11,481.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $10,000.00 Typical High $16,982.44 | Facility | None | $6,606.93 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $4,073.80 Typical High $8,709.64 | Professional | None | $1,148.15 | $4,073.80 | $8,709.64 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $6,165.95 Typical High $12,589.25 | Professional | 50 · Both sides | $1,737.80 | $6,165.95 | $12,589.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $2,570.40 Typical High $5,248.07 | Professional | 62 · Two surgeons | $724.44 | $2,570.40 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $660.69 Typical High $1,348.96 | Professional | 80 · Assistant surgeon | $186.21 | $660.69 | $1,348.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $575.44 Typical High $1,174.90 | Professional | AS · PA/NP assist | $162.18 | $575.44 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,570.40 Typical High $3,890.45 | Facility | None | $812.83 | $2,570.40 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $3,162.28 Typical High $5,495.41 | Professional | None | $1,737.80 | $3,162.28 | $5,495.41 |
DeanCare Setting Facility Modifier None Typical Low $1,174.90 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,174.90 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $3,630.78 | Professional | None | $2,137.96 | $2,630.27 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $3,715.35 Typical High $5,888.44 | Professional | None | $1,318.26 | $3,715.35 | $5,888.44 |
Network Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $2,187.76 | Facility | None | $1,479.11 | $2,089.30 | $2,187.76 |
Network Health Setting Professional Modifier None Typical Low $1,445.44 Median $2,511.89 Typical High $3,467.37 | Professional | None | $1,445.44 | $2,511.89 | $3,467.37 |
Prevea360 Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,238.72 | Facility | None | $912.01 | $1,258.93 | $2,238.72 |
Quartz Setting Professional Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $4,677.35 | Professional | None | $1,096.48 | $2,511.89 | $4,677.35 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,737.80 | $2,398.83 |
Security Health Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $5,248.07 | Professional | None | $5,248.07 | $5,248.07 | $5,248.07 |
Security Health Setting Professional Modifier None Typical Low $4,897.79 Median $6,456.54 Typical High $7,413.10 | Professional | None | $4,897.79 | $6,456.54 | $7,413.10 |
The Alliance Setting Professional Modifier None Typical Low $2,187.76 Median $6,025.60 Typical High $8,511.38 | Professional | None | $2,187.76 | $6,025.60 | $8,511.38 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $3,715.35 Typical High $5,754.40 | Professional | None | $1,230.27 | $3,715.35 | $5,754.40 |
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 $660.69 Median $660.69 Typical High $5,754.40 | Professional | 52 · Reduced service | $660.69 | $660.69 | $5,754.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $2,290.87 | Professional | 53 · Discontinued | $263.03 | $263.03 | $2,290.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $8,709.64 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $8,709.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $1,737.80 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $1,737.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $1,148.15 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $1,148.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $8,128.31 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $8,128.31 |
Where Wisconsin 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.