How much rates vary
Facilitymedian $851 · 10th to 90th $245 to $11,220Professionalmedian $275 · 10th to 90th $224 to $447
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 $245.47 Median $251.19 Typical High $794.33 | Facility | None | $245.47 | $251.19 | $794.33 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $363.08 | Professional | None | $245.47 | $251.19 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $16,218.10 | Facility | None | $5,888.44 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $398.11 | Professional | None | $223.87 | $275.42 | $398.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $141.25 Median $169.82 Typical High $251.19 | Professional | 62 · Two surgeons | $141.25 | $169.82 | $251.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $35.48 Median $43.65 Typical High $63.10 | Professional | 80 · Assistant surgeon | $35.48 | $43.65 | $63.10 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $30.90 Median $38.02 Typical High $54.95 | Professional | AS · PA/NP assist | $30.90 | $38.02 | $54.95 |
CareSource Setting Facility Modifier None Typical Low $208.93 Median $251.19 Typical High $389.05 | Facility | None | $208.93 | $251.19 | $389.05 |
CareSource Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $407.38 | Professional | None | $269.15 | $346.74 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $426.58 Typical High $794.33 | Facility | None | $34.67 | $426.58 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $1,621.81 | Professional | None | $251.19 | $380.19 | $1,621.81 |
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 $229.09 Median $323.59 Typical High $467.74 | Professional | None | $229.09 | $323.59 | $467.74 |
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 $123.03 Median $125.89 Typical High $134.90 | Professional | 52 · Reduced service | $123.03 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $50.12 Typical High $53.70 | Professional | 53 · Discontinued | $48.98 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $190.55 Typical High $204.17 | Professional | 54 · Surgery only | $186.21 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $38.02 Typical High $40.74 | Professional | 55 · Aftercare only | $37.15 | $38.02 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $25.12 Typical High $26.92 | Professional | 56 · Pre-op care only | $24.55 | $25.12 | $26.92 |
Where Kentucky 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.