How much rates vary
Facilitymedian $10,233 · 10th to 90th $2,512 to $17,783Professionalmedian $1,862 · 10th to 90th $1,380 to $2,818
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 $10,964.78 | Facility | None | $2,570.40 | $5,495.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,380.38 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $11,481.54 Typical High $18,620.87 | Facility | None | $7,413.10 | $11,481.54 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,548.82 | $2,089.30 | $2,884.03 |
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 $1,445.44 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,737.80 | $2,454.71 |
Denver HMP Setting Facility Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $3,162.28 | Facility | None | $1,380.38 | $1,778.28 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,412.54 | $1,778.28 | $2,818.38 |
Select Health Setting Facility Modifier None Typical Low $1,288.25 Median $2,570.40 Typical High $2,691.53 | Facility | None | $1,288.25 | $2,570.40 | $2,691.53 |
Select Health Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,348.96 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $4,265.80 Typical High $13,182.57 | Facility | None | $1,905.46 | $4,265.80 | $13,182.57 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,737.80 | $2,754.23 |
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 $676.08 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $275.42 Typical High $331.13 | Professional | 53 · Discontinued | $269.15 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,047.13 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,023.29 | $1,047.13 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $208.93 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $208.93 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $138.04 Typical High $165.96 | Professional | 56 · Pre-op care only | $134.90 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $977.24 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $954.99 | $977.24 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $831.76 Typical High $1,348.96 | Professional | 62 · Two surgeons | $645.65 | $831.76 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $213.80 Typical High $363.08 | Professional | 80 · Assistant surgeon | $165.96 | $213.80 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $186.21 Typical High $302.00 | Professional | AS · PA/NP assist | $144.54 | $186.21 | $302.00 |
Where Colorado sits
The same service costs 8.5 times more in Maine than in Delaware. 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 $28,081DE $3,299
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.