How much rates vary
Facilitymedian $6,310 · 10th to 90th $871 to $12,589Professionalmedian $186 · 10th to 90th $138 to $282
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 $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $186.21 | Professional | None | $134.90 | $138.04 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $295.12 | Professional | None | $154.88 | $208.93 | $295.12 |
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 $154.88 Median $177.83 Typical High $257.04 | Professional | None | $154.88 | $177.83 | $257.04 |
Denver HMP Setting Facility Modifier None Typical Low $138.04 Median $190.55 Typical High $309.03 | Facility | None | $138.04 | $190.55 | $309.03 |
Kaiser Permanente Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $275.42 | Professional | None | $144.54 | $173.78 | $275.42 |
Select Health Setting Facility Modifier None Typical Low $123.03 Median $251.19 Typical High $263.03 | Facility | None | $123.03 | $251.19 | $263.03 |
Select Health Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $199.53 | Professional | None | $114.82 | $134.90 | $199.53 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $144.54 Median $181.97 Typical High $288.40 | Professional | None | $144.54 | $181.97 | $288.40 |
8 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 $69.18 Median $69.18 Typical High $85.11 | Professional | 52 · Reduced service | $69.18 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $33.88 | Professional | 53 · Discontinued | $27.54 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 54 · Surgery only | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $25.70 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $16.98 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $16.98 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $72.44 Median $91.20 Typical High $177.83 | Professional | 62 · Two surgeons | $72.44 | $91.20 | $177.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.62 Median $22.91 Typical High $44.67 | Professional | 80 · Assistant surgeon | $18.62 | $22.91 | $44.67 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $16.22 Median $20.42 Typical High $38.90 | Professional | AS · PA/NP assist | $16.22 | $20.42 | $38.90 |
Where Colorado sits
The same service costs 36.6 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 $16,031MT $438
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.