How much rates vary
Facilitymedian $3,802 · 10th to 90th $525 to $19,055Professionalmedian $1,047 · 10th to 90th $138 to $1,479
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 $2,951.21 Median $5,754.40 Typical High $12,022.64 | Facility | None | $2,951.21 | $5,754.40 | $12,022.64 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $3,630.78 | Professional | None | $1,071.52 | $1,071.52 | $3,630.78 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $9,120.11 Typical High $22,908.68 | Facility | None | $1,122.02 | $9,120.11 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,445.44 | Professional | None | $891.25 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $660.69 Typical High $912.01 | Professional | 62 · Two surgeons | $562.34 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $234.42 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $144.54 Typical High $204.17 | Professional | AS · PA/NP assist | $123.03 | $144.54 | $204.17 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,288.25 | Professional | None | $1,122.02 | $1,122.02 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,148.15 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,047.13 Median $1,148.15 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,148.15 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $870.96 Typical High $1,380.38 | Professional | None | $97.72 | $870.96 | $1,380.38 |
SummaCare Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,047.13 | $1,230.27 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,778.28 | Professional | None | $912.01 | $1,148.15 | $1,778.28 |
2 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 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $977.24 |
Ambetter Setting Professional Modifier 58 · Staged procedure Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 58 · Staged procedure | $457.09 | $457.09 | $457.09 |
Where Ohio sits
The same service costs 15.9 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 $27,116MD $1,710
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.