How much rates vary
Facilitymedian $1,778 · 10th to 90th $832 to $12,023Professionalmedian $1,349 · 10th to 90th $955 to $1,905
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 $1,071.52 Median $1,380.38 Typical High $2,089.30 | Facility | None | $1,071.52 | $1,380.38 | $2,089.30 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,380.38 | Professional | None | $1,071.52 | $1,202.26 | $1,380.38 |
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 $912.01 Median $1,348.96 Typical High $1,548.82 | Professional | None | $912.01 | $1,348.96 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $213.80 Typical High $245.47 | Professional | 80 · Assistant surgeon | $147.91 | $213.80 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $190.55 Typical High $213.80 | Professional | AS · PA/NP assist | $128.82 | $190.55 | $213.80 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,659.59 | Facility | None | $870.96 | $1,047.13 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,698.24 | Professional | None | $912.01 | $1,288.25 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,778.28 | Facility | None | $34.67 | $512.86 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $6,456.54 | Professional | None | $1,047.13 | $1,318.26 | $6,456.54 |
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 $12,022.64 | Facility | None | $977.24 | $1,862.09 | $12,022.64 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $2,041.74 | Professional | None | $1,047.13 | $1,659.59 | $2,041.74 |
2 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 $812.83 Median $831.76 Typical High $1,023.29 | Professional | 54 · Surgery only | $812.83 | $831.76 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $954.99 |
Where Kentucky sits
The same service costs 8.7 times more in Maine than in Kentucky. 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 $27,149KY $3,127
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.