How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $1,738 · 10th to 90th $1,318 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 $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 $1,258.93 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,318.26 | $1,819.70 |
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 $1,412.54 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,949.84 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,659.59 | $2,290.87 |
Denver HMP Setting Facility Modifier None Typical Low $1,202.26 Median $1,621.81 Typical High $3,019.95 | Facility | None | $1,202.26 | $1,621.81 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,698.24 | $2,691.53 |
Select Health Setting Facility Modifier None Typical Low $1,230.27 Median $2,454.71 Typical High $2,570.40 | Facility | None | $1,230.27 | $2,454.71 | $2,570.40 |
Select Health Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,288.25 | $1,949.84 |
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 $1,288.25 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,288.25 | $1,659.59 | $2,630.27 |
9 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 $645.65 Median $660.69 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $660.69 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $257.04 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $199.53 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $794.33 Typical High $1,318.26 | Professional | 62 · Two surgeons | $602.56 | $794.33 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $199.53 Typical High $338.84 | Professional | 80 · Assistant surgeon | $151.36 | $199.53 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $173.78 Typical High $295.12 | Professional | AS · PA/NP assist | $131.83 | $173.78 | $295.12 |
Where Colorado sits
The same service costs 9.0 times more in Maine than in Maryland. 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 $17,547MD $1,943
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.