How much rates vary
Facilitymedian $1,122 · 10th to 90th $513 to $7,244Professionalmedian $158 · 10th to 90th $107 to $295
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 $112.20 Median $5,370.32 Typical High $7,943.28 | Facility | None | $112.20 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $144.54 | Professional | None | $112.20 | $120.23 | $144.54 |
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 $102.33 Median $162.18 Typical High $275.42 | Professional | None | $102.33 | $162.18 | $275.42 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $77.62 Median $107.15 Typical High $177.83 | Professional | 62 · Two surgeons | $77.62 | $107.15 | $177.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $29.51 Typical High $46.77 | Professional | 80 · Assistant surgeon | $19.50 | $29.51 | $46.77 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $23.44 Typical High $39.81 | Professional | AS · PA/NP assist | $16.98 | $23.44 | $39.81 |
CareSource Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $831.76 Typical High $4,265.80 | Facility | None | $512.86 | $831.76 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $346.74 | Professional | None | $131.83 | $204.17 | $346.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $776.25 | Professional | None | $120.23 | $147.91 | $776.25 |
Oscar Health Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $107.15 Median $190.55 Typical High $363.08 | Professional | None | $107.15 | $190.55 | $363.08 |
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 $56.23 Median $56.23 Typical High $72.44 | Professional | 52 · Reduced service | $56.23 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $28.84 | Professional | 53 · Discontinued | $22.39 | $22.39 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $83.18 Typical High $109.65 | Professional | 54 · Surgery only | $83.18 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $21.88 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $14.45 |
Where Georgia sits
The same service costs 47.1 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 $16,363MT $348
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.