How much rates vary
Facilitymedian $3,981 · 10th to 90th $501 to $19,055Professionalmedian $1,585 · 10th to 90th $155 to $2,291
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 $1,737.80 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,737.80 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $6,025.60 | Professional | None | $1,737.80 | $1,737.80 | $6,025.60 |
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 $1,348.96 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,348.96 | $1,659.59 | $2,290.87 |
CareSource Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,819.70 | $1,819.70 | $2,089.30 |
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 $1,659.59 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,659.59 | $1,862.09 | $3,019.95 |
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 $1,659.59 Median $1,862.09 Typical High $3,019.95 | Professional | None | $1,659.59 | $1,862.09 | $3,019.95 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $1,230.27 Typical High $2,089.30 | Professional | None | $134.90 | $1,230.27 | $2,089.30 |
SummaCare Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,659.59 | $1,949.84 |
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 $1,479.11 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,479.11 | $1,862.09 | $2,884.03 |
10 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 $870.96 Median $870.96 Typical High $1,122.02 | Professional | 52 · Reduced service | $870.96 | $870.96 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $457.09 | Professional | 53 · Discontinued | $346.74 | $346.74 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $229.09 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,584.89 |
Ambetter Setting Professional Modifier 22 · Increased work Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | 22 · Increased work | $2,454.71 | $2,454.71 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,047.13 Typical High $1,445.44 | Professional | 62 · Two surgeons | $851.14 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $269.15 Typical High $371.54 | Professional | 80 · Assistant surgeon | $213.80 | $269.15 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $234.42 Typical High $323.59 | Professional | AS · PA/NP assist | $186.21 | $234.42 | $323.59 |
Where Ohio sits
The same service costs 12.0 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 $28,594MD $2,382
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.