How much rates vary
Facilitymedian $3,020 · 10th to 90th $832 to $11,220Professionalmedian $1,820 · 10th to 90th $1,479 to $2,630
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 $1,819.70 Median $2,137.96 Typical High $2,290.87 | Facility | None | $1,819.70 | $2,137.96 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,819.70 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $16,218.10 | Facility | None | $5,888.44 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,819.70 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,122.02 Typical High $1,513.56 | Professional | 62 · Two surgeons | $933.25 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $288.40 Typical High $389.05 | Professional | 80 · Assistant surgeon | $239.88 | $288.40 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $251.19 Typical High $338.84 | Professional | AS · PA/NP assist | $208.93 | $251.19 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,754.23 | Facility | None | $1,445.44 | $1,737.80 | $2,754.23 |
CareSource Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,548.82 | $2,137.96 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,019.95 | Facility | None | $34.67 | $512.86 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $10,000.00 | Professional | None | $1,737.80 | $2,041.74 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $2,884.03 | Professional | None | $1,698.24 | $2,290.87 | $2,884.03 |
4 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 $1,698.24 | Professional | 54 · Surgery only | $1,348.96 | $1,380.38 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $275.42 Typical High $338.84 | Professional | 55 · Aftercare only | $269.15 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $229.09 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,288.25 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,288.25 | $1,584.89 |
Where Kentucky 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.