How much rates vary
Facilitymedian $1,202 · 10th to 90th $501 to $8,913Professionalmedian $372 · 10th to 90th $251 to $631
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 $251.19 Median $5,370.32 Typical High $7,943.28 | Facility | None | $251.19 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $269.15 Typical High $741.31 | Professional | None | $251.19 | $269.15 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,630.27 Typical High $12,302.69 | Facility | None | $831.76 | $2,630.27 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $575.44 | Professional | None | $245.47 | $371.54 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $239.88 Typical High $363.08 | Professional | 62 · Two surgeons | $173.78 | $239.88 | $363.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $44.67 Median $63.10 Typical High $97.72 | Professional | 80 · Assistant surgeon | $44.67 | $63.10 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.90 Median $53.70 Typical High $81.28 | Professional | AS · PA/NP assist | $38.90 | $53.70 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $436.52 Typical High $741.31 | Professional | None | $309.03 | $436.52 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $251.19 Median $316.23 Typical High $891.25 | Professional | None | $251.19 | $316.23 | $891.25 |
Oscar Health Setting Professional Modifier None Typical Low $275.42 Median $457.09 Typical High $602.56 | Professional | None | $275.42 | $457.09 | $602.56 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $630.96 | Professional | None | $281.84 | $398.11 | $630.96 |
5 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 $125.89 Median $125.89 Typical High $151.36 | Professional | 52 · Reduced service | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | 53 · Discontinued | $50.12 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $30.20 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $30.20 |
Where Georgia sits
The same service costs 32.0 times more in Maine than in Montana. 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 $26,674MT $834
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.