How much rates vary
Facilitymedian $5,754 · 10th to 90th $794 to $19,055Professionalmedian $1,288 · 10th to 90th $178 to $1,950
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 $2,511.89 Median $9,120.11 Typical High $12,589.25 | Facility | None | $2,511.89 | $9,120.11 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $4,677.35 | Professional | None | $1,380.38 | $1,380.38 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $9,549.93 Typical High $22,908.68 | Facility | None | $1,122.02 | $9,549.93 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $812.83 Typical High $1,202.26 | Professional | 62 · Two surgeons | $691.83 | $812.83 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $302.00 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $181.97 Typical High $263.03 | Professional | AS · PA/NP assist | $154.88 | $181.97 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,698.24 | $1,698.24 | $1,698.24 |
CareSource Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,445.44 | $1,445.44 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,479.11 | $2,344.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,479.11 | $2,344.23 |
Molina Setting Professional Modifier None Typical Low $131.83 Median $1,122.02 Typical High $1,778.28 | Professional | None | $131.83 | $1,122.02 | $1,778.28 |
SummaCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,318.26 | $1,548.82 |
United Setting Facility Modifier None Typical Low $851.14 Median $2,511.89 Typical High $8,317.64 | Facility | None | $851.14 | $2,511.89 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,479.11 | $2,238.72 |
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 $691.83 Median $691.83 Typical High $912.01 | Professional | 52 · Reduced service | $691.83 | $691.83 | $912.01 |
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 $1,380.38 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $275.42 |
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 $1,288.25 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,288.25 |
Where Ohio 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.