How much rates vary
Facilitymedian $3,802 · 10th to 90th $479 to $19,055Professionalmedian $288 · 10th to 90th $229 to $479
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 $288.40 Median $10,232.93 Typical High $13,803.84 | Facility | None | $288.40 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $1,348.96 | Professional | None | $263.03 | $263.03 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $9,549.93 Typical High $22,908.68 | Facility | None | $1,148.15 | $9,549.93 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $426.58 | Professional | None | $218.78 | $263.03 | $426.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $138.04 Median $165.96 Typical High $263.03 | Professional | 62 · Two surgeons | $138.04 | $165.96 | $263.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.90 Median $42.66 Typical High $74.13 | Professional | 80 · Assistant surgeon | $38.90 | $42.66 | $74.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $36.31 Typical High $58.88 | Professional | AS · PA/NP assist | $30.20 | $36.31 | $58.88 |
Aultcare Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | None | $436.52 | $436.52 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $562.34 | Professional | None | $257.04 | $295.12 | $562.34 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $562.34 | Professional | None | $257.04 | $295.12 | $562.34 |
Molina Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $389.05 | Professional | None | $229.09 | $295.12 | $389.05 |
SummaCare Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $371.54 | Professional | None | $245.47 | $288.40 | $371.54 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $229.09 Median $302.00 Typical High $616.60 | Professional | None | $229.09 | $302.00 | $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 $131.83 Median $131.83 Typical High $602.56 | Professional | 52 · Reduced service | $131.83 | $131.83 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $239.88 | Professional | 53 · Discontinued | $52.48 | $52.48 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $912.01 | Professional | 54 · Surgery only | $194.98 | $194.98 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $181.97 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $120.23 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $120.23 |
Where Ohio 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.