How much rates vary
Facilitymedian $1,380 · 10th to 90th $550 to $6,457Professionalmedian $1,175 · 10th to 90th $776 to $1,995
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 $1,096.48 | Professional | None | $831.76 | $831.76 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $8,128.31 | Facility | None | $588.84 | $1,862.09 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $1,174.90 Typical High $1,862.09 | Professional | None | $691.83 | $1,174.90 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $776.25 Typical High $1,318.26 | Professional | 62 · Two surgeons | $562.34 | $776.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $218.78 Typical High $338.84 | Professional | 80 · Assistant surgeon | $144.54 | $218.78 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $165.96 Typical High $295.12 | Professional | AS · PA/NP assist | $120.23 | $165.96 | $295.12 |
CareSource Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $2,398.83 | Professional | None | $912.01 | $1,318.26 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,698.24 | Professional | None | $954.99 | $1,174.90 | $1,698.24 |
Oscar Health Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $851.14 Median $1,479.11 Typical High $5,011.87 | Facility | None | $851.14 | $1,479.11 | $5,011.87 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,380.38 Typical High $2,691.53 | Professional | None | $758.58 | $1,380.38 | $2,691.53 |
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 $549.54 | Professional | 52 · Reduced service | $416.87 | $416.87 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 53 · Discontinued | $165.96 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $812.83 | Professional | 54 · Surgery only | $630.96 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $162.18 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $758.58 |
Where Georgia sits
The same service costs 8.8 times more in Maine than in Delaware. 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 $16,945DE $1,928
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.