How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $2,344 · 10th to 90th $1,778 to $3,548
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 $1,737.80 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,778.28 | $2,398.83 |
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 $1,905.46 Median $2,570.40 Typical High $3,630.78 | Professional | None | $1,905.46 | $2,570.40 | $3,630.78 |
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 $1,737.80 Median $2,238.72 Typical High $3,090.30 | Professional | None | $1,737.80 | $2,238.72 | $3,090.30 |
Denver HMP Setting Facility Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $4,073.80 | Facility | None | $1,778.28 | $2,187.76 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,238.72 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,238.72 | $3,548.13 |
Select Health Setting Facility Modifier None Typical Low $1,621.81 Median $3,235.94 Typical High $3,388.44 | Facility | None | $1,621.81 | $3,235.94 | $3,388.44 |
Select Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,698.24 | $2,570.40 |
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 $1,737.80 Median $2,187.76 Typical High $3,548.13 | Professional | None | $1,737.80 | $2,187.76 | $3,548.13 |
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 $870.96 Median $870.96 Typical High $1,047.13 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $354.81 Typical High $416.87 | Professional | 53 · Discontinued | $346.74 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,318.26 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,288.25 | $1,318.26 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $316.23 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $208.93 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,230.27 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,230.27 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,096.48 Typical High $1,659.59 | Professional | 62 · Two surgeons | $851.14 | $1,096.48 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $275.42 Typical High $426.58 | Professional | 80 · Assistant surgeon | $218.78 | $275.42 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $245.47 Typical High $371.54 | Professional | AS · PA/NP assist | $190.55 | $245.47 | $371.54 |
Where Colorado sits
The same service costs 7.6 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 $18,140MD $2,382
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.