How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $7,943Professionalmedian $3,311 · 10th to 90th $2,089 to $5,754
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 $2,398.83 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,398.83 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,398.83 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $12,589.25 | Facility | None | $707.95 | $2,290.87 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $3,311.31 Typical High $5,623.41 | Professional | None | $1,949.84 | $3,311.31 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $2,137.96 Typical High $3,715.35 | Professional | 62 · Two surgeons | $1,479.11 | $2,137.96 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $575.44 Typical High $954.99 | Professional | 80 · Assistant surgeon | $380.19 | $575.44 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $331.13 Median $467.74 Typical High $831.76 | Professional | AS · PA/NP assist | $331.13 | $467.74 | $831.76 |
CareSource Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $2,511.89 Median $3,715.35 Typical High $6,165.95 | Professional | None | $2,511.89 | $3,715.35 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $4,897.79 | Professional | None | $2,454.71 | $2,818.38 | $4,897.79 |
Oscar Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
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 $2,238.72 Median $3,890.45 Typical High $7,413.10 | Professional | None | $2,238.72 | $3,890.45 | $7,413.10 |
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 $1,202.26 Median $1,202.26 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $602.56 | Professional | 53 · Discontinued | $478.63 | $478.63 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $2,238.72 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $446.68 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $302.00 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $2,089.30 |
Where Georgia sits
The same service costs 11.8 times more in Maine than in Texas. 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 $29,935TX $2,543
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.