How much rates vary
Facilitymedian $2,884 · 10th to 90th $813 to $10,471Professionalmedian $331 · 10th to 90th $224 to $589
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 $239.88 Median $7,413.10 Typical High $15,488.17 | Facility | None | $239.88 | $7,413.10 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $537.03 | Professional | None | $239.88 | $257.04 | $537.03 |
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 $204.17 Median $331.13 Typical High $549.54 | Professional | None | $204.17 | $331.13 | $549.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $162.18 Median $229.09 Typical High $380.19 | Professional | 62 · Two surgeons | $162.18 | $229.09 | $380.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $66.07 Typical High $107.15 | Professional | 80 · Assistant surgeon | $39.81 | $66.07 | $107.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $50.12 Typical High $85.11 | Professional | AS · PA/NP assist | $36.31 | $50.12 | $85.11 |
CareSource Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $891.25 Typical High $4,265.80 | Facility | None | $512.86 | $891.25 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $741.31 | Professional | None | $281.84 | $426.58 | $741.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $1,659.59 | Professional | None | $257.04 | $316.23 | $1,659.59 |
Oscar Health Setting Professional Modifier None Typical Low $281.84 Median $380.19 Typical High $416.87 | Professional | None | $281.84 | $380.19 | $416.87 |
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 $229.09 Median $407.38 Typical High $776.25 | Professional | None | $229.09 | $407.38 | $776.25 |
5 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 $120.23 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $47.86 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $234.42 | Professional | 54 · Surgery only | $177.83 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $46.77 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $30.90 |
Where Georgia sits
The same service costs 36.6 times more in Maine than in Montana. 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 $27,224MT $743
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.