How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $2,455 · 10th to 90th $1,622 to $4,571
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 $1,737.80 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,737.80 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,949.84 Typical High $4,897.79 | Professional | None | $1,737.80 | $1,949.84 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $8,128.31 | Facility | None | $588.84 | $1,862.09 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $4,265.80 | Professional | None | $1,445.44 | $2,454.71 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,621.81 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,122.02 | $1,621.81 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $436.52 Typical High $707.95 | Professional | 80 · Assistant surgeon | $281.84 | $436.52 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $346.74 Typical High $616.60 | Professional | AS · PA/NP assist | $245.47 | $346.74 | $616.60 |
CareSource Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,818.38 Typical High $5,128.61 | Professional | None | $1,905.46 | $2,818.38 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $2,951.21 | Professional | None | $1,949.84 | $2,187.76 | $2,951.21 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $2,818.38 Typical High $3,162.28 | Professional | None | $1,479.11 | $2,818.38 | $3,162.28 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,884.03 Typical High $5,623.41 | Professional | None | $1,584.89 | $2,884.03 | $5,623.41 |
6 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 $1,148.15 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | 53 · Discontinued | $354.81 | $354.81 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $229.09 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,584.89 |
Where Georgia 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.