How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $2,512 · 10th to 90th $1,905 to $3,890
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,819.70 | $1,905.46 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $3,981.07 | Professional | None | $2,089.30 | $2,818.38 | $3,981.07 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,398.83 | $3,388.44 |
Denver HMP Setting Facility Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $4,365.16 | Facility | None | $1,905.46 | $2,344.23 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $3,890.45 | Professional | None | $1,949.84 | $2,454.71 | $3,890.45 |
Select Health Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $3,715.35 | Facility | None | $1,737.80 | $3,548.13 | $3,715.35 |
Select Health Setting Professional Modifier None Typical Low $1,584.89 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,862.09 | $2,818.38 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $3,890.45 | Professional | None | $1,862.09 | $2,398.83 | $3,890.45 |
9 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 $954.99 Median $954.99 Typical High $1,122.02 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | 53 · Discontinued | $380.19 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,445.44 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,412.54 | $1,445.44 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $288.40 Typical High $338.84 | Professional | 55 · Aftercare only | $281.84 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,348.96 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,348.96 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,148.15 Typical High $1,949.84 | Professional | 62 · Two surgeons | $912.01 | $1,148.15 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $295.12 Typical High $489.78 | Professional | 80 · Assistant surgeon | $229.09 | $295.12 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $257.04 Typical High $426.58 | Professional | AS · PA/NP assist | $199.53 | $257.04 | $426.58 |
Where Colorado sits
The same service costs 7.2 times more in Maine than in Maryland. 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 $18,361MD $2,558
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.