How much rates vary
Facilitymedian $1,230 · 10th to 90th $513 to $8,913Professionalmedian $1,202 · 10th to 90th $813 to $2,089
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 $831.76 Median $5,370.32 Typical High $7,943.28 | Facility | None | $831.76 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $2,344.23 | Professional | None | $831.76 | $831.76 | $2,344.23 |
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 $812.83 Median $1,202.26 Typical High $1,819.70 | Professional | None | $812.83 | $1,202.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $741.31 Typical High $1,174.90 | Professional | 62 · Two surgeons | $549.54 | $741.31 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $194.98 Typical High $302.00 | Professional | 80 · Assistant surgeon | $138.04 | $194.98 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $165.96 Typical High $263.03 | Professional | AS · PA/NP assist | $123.03 | $165.96 | $263.03 |
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 $977.24 Median $1,348.96 Typical High $2,290.87 | Professional | None | $977.24 | $1,348.96 | $2,290.87 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,819.70 | Professional | None | $831.76 | $1,000.00 | $1,819.70 |
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 $891.25 Median $1,288.25 Typical High $2,238.72 | Professional | None | $891.25 | $1,288.25 | $2,238.72 |
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 $416.87 Median $416.87 Typical High $436.52 | Professional | 52 · Reduced service | $416.87 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $173.78 | Professional | 53 · Discontinued | $165.96 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $660.69 | Professional | 54 · Surgery only | $616.60 | $616.60 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $616.60 |
Where Georgia sits
The same service costs 18.1 times more in Maine than in Arkansas. 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 $27,451AR $1,513
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.