How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,692 to $17,783Professionalmedian $2,455 · 10th to 90th $1,862 to $3,715
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 $10,715.19 | Facility | None | $2,570.40 | $5,495.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,819.70 | $1,862.09 | $2,454.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,413.10 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,754.23 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,754.23 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $4,786.30 | Facility | None | $645.65 | $2,290.87 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,905.46 | $2,344.23 | $3,235.94 |
Denver HMP Setting Facility Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $4,265.80 | Facility | None | $1,862.09 | $2,344.23 | $4,265.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,344.23 | $3,715.35 |
Select Health Setting Facility Modifier None Typical Low $1,698.24 Median $3,388.44 Typical High $3,548.13 | Facility | None | $1,698.24 | $3,388.44 | $3,548.13 |
Select Health Setting Professional Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,778.28 | $2,691.53 |
United Setting Facility Modifier None Typical Low $2,511.89 Median $6,025.60 Typical High $15,488.17 | Facility | None | $2,511.89 | $6,025.60 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $3,715.35 | Professional | None | $1,819.70 | $2,344.23 | $3,715.35 |
7 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 54 · Surgery only Typical Low $1,348.96 Median $1,380.38 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,348.96 | $1,380.38 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $275.42 Typical High $331.13 | Professional | 55 · Aftercare only | $269.15 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $186.21 Typical High $218.78 | Professional | 56 · Pre-op care only | $181.97 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,288.25 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,288.25 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,023.29 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $323.59 Typical High $478.63 | Professional | 80 · Assistant surgeon | $257.04 | $323.59 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $281.84 Typical High $416.87 | Professional | AS · PA/NP assist | $229.09 | $281.84 | $416.87 |
Where Colorado sits
The same service costs 7.2 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 $28,702DE $3,966
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.