How much rates vary
Facilitymedian $2,570 · 10th to 90th $468 to $9,772Professionalmedian $372 · 10th to 90th $251 to $1,230
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 $302.00 Median $4,897.79 Typical High $7,762.47 | Facility | None | $302.00 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $407.38 | Professional | None | $234.42 | $251.19 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $512.86 | Professional | None | $288.40 | $389.05 | $512.86 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $181.97 Median $245.47 Typical High $323.59 | Professional | 62 · Two surgeons | $181.97 | $245.47 | $323.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $45.71 Median $64.57 Typical High $81.28 | Professional | 80 · Assistant surgeon | $45.71 | $64.57 | $81.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $56.23 Typical High $70.79 | Professional | AS · PA/NP assist | $40.74 | $56.23 | $70.79 |
BCBS Kansas City Setting Professional Modifier None Typical Low $245.47 Median $269.15 Typical High $371.54 | Professional | None | $245.47 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $346.74 Typical High $602.56 | Professional | None | $263.03 | $346.74 | $602.56 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,071.52 Typical High $6,918.31 | Facility | None | $54.95 | $1,071.52 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $602.56 Typical High $4,265.80 | Professional | None | $245.47 | $602.56 | $4,265.80 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $245.47 Median $309.03 Typical High $616.60 | Professional | None | $245.47 | $309.03 | $616.60 |
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 $117.49 Median $125.89 Typical High $134.90 | Professional | 52 · Reduced service | $117.49 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $50.12 Typical High $53.70 | Professional | 53 · Discontinued | $46.77 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $186.21 Typical High $204.17 | Professional | 54 · Surgery only | $177.83 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $37.15 Typical High $40.74 | Professional | 55 · Aftercare only | $35.48 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $25.12 Typical High $26.92 | Professional | 56 · Pre-op care only | $23.44 | $25.12 | $26.92 |
Where Missouri 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.