How much rates vary
Facilitymedian $6,166 · 10th to 90th $708 to $19,055Professionalmedian $1,738 · 10th to 90th $219 to $2,570
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 $2,511.89 Median $6,309.57 Typical High $12,589.25 | Facility | None | $2,511.89 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $6,309.57 | Professional | None | $1,819.70 | $1,819.70 | $6,309.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $9,549.93 Typical High $22,908.68 | Facility | None | $1,122.02 | $9,549.93 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,737.80 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | 62 · Two surgeons | $933.25 | $1,096.48 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $426.58 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $371.54 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,187.76 | Professional | None | $1,949.84 | $1,949.84 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,778.28 | $1,995.26 | $3,162.28 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,778.28 | $1,995.26 | $3,162.28 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,479.11 Typical High $2,344.23 | Professional | None | $165.96 | $1,479.11 | $2,344.23 |
SummaCare Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,089.30 | Professional | None | $1,778.28 | $1,778.28 | $2,089.30 |
United Setting Facility Modifier None Typical Low $912.01 Median $3,388.44 Typical High $10,471.29 | Facility | None | $912.01 | $3,388.44 | $10,471.29 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $3,019.95 | Professional | None | $1,548.82 | $1,949.84 | $3,019.95 |
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 $1,380.38 Median $1,380.38 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $371.54 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,698.24 |
Where Ohio 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.