How much rates vary
Facilitymedian $2,630 · 10th to 90th $550 to $9,772Professionalmedian $1,950 · 10th to 90th $1,288 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 $1,778.28 Median $7,079.46 Typical High $15,488.17 | Facility | None | $1,778.28 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $3,801.89 | Professional | None | $1,380.38 | $1,548.82 | $3,801.89 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,288.25 | $1,659.59 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 80 · Assistant surgeon | $204.17 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,691.53 Typical High $12,302.69 | Facility | None | $831.76 | $2,691.53 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $3,162.28 | Professional | None | $1,148.15 | $1,949.84 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,318.26 Typical High $2,187.76 | Professional | 62 · Two surgeons | $933.25 | $1,318.26 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $363.08 Typical High $575.44 | Professional | 80 · Assistant surgeon | $234.42 | $363.08 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $281.84 Typical High $489.78 | Professional | AS · PA/NP assist | $208.93 | $281.84 | $489.78 |
CareSource 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 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,511.89 | Facility | None | $457.09 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,981.07 | Professional | None | $1,513.56 | $2,238.72 | $3,981.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,548.82 | $1,862.09 | $3,019.95 |
Oscar Health Setting Professional Modifier None Typical Low $1,621.81 Median $2,238.72 Typical High $2,454.71 | Professional | None | $1,621.81 | $2,238.72 | $2,454.71 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $8,709.64 | Facility | None | $1,258.93 | $2,884.03 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $2,290.87 Typical High $4,466.84 | Professional | None | $1,318.26 | $2,290.87 | $4,466.84 |
7 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 $691.83 Median $691.83 Typical High $891.25 | Professional | 52 · Reduced service | $691.83 | $691.83 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $363.08 | Professional | 53 · Discontinued | $275.42 | $275.42 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $181.97 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,258.93 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | 59 · Distinct service | $2,570.40 | $2,570.40 | $2,570.40 |
Where Georgia 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.