How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $1,995 · 10th to 90th $1,660 to $12,882
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 $1,778.28 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,621.81 | $1,862.09 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,949.84 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,230.27 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,023.29 | $1,230.27 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $309.03 Typical High $457.09 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $269.15 Typical High $398.11 | Professional | AS · PA/NP assist | $223.87 | $269.15 | $398.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,659.59 | $1,819.70 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $3,548.13 | Professional | None | $1,659.59 | $1,905.46 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,995.26 Median $12,882.50 Typical High $12,882.50 | Professional | None | $1,995.26 | $12,882.50 | $12,882.50 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,398.83 Typical High $4,265.80 | Professional | None | $1,659.59 | $2,398.83 | $4,265.80 |
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 $812.83 Median $870.96 Typical High $977.24 | Professional | 52 · Reduced service | $812.83 | $870.96 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $346.74 Typical High $398.11 | Professional | 53 · Discontinued | $323.59 | $346.74 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,288.25 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,230.27 | $1,288.25 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $257.04 Typical High $295.12 | Professional | 55 · Aftercare only | $245.47 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $173.78 Typical High $199.53 | Professional | 56 · Pre-op care only | $162.18 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,202.26 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,202.26 | $1,380.38 |
Where Missouri 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.