How much rates vary
Facilitymedian $2,399 · 10th to 90th $479 to $7,762Professionalmedian $708 · 10th to 90th $91 to $1,047
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 $933.25 Median $10,232.93 Typical High $13,803.84 | Facility | None | $933.25 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,548.82 | Professional | None | $776.25 | $776.25 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $741.31 Median $3,311.31 Typical High $6,456.54 | Facility | None | $741.31 | $3,311.31 | $6,456.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $1,000.00 | Professional | None | $588.84 | $691.83 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $436.52 Typical High $645.65 | Professional | 62 · Two surgeons | $371.54 | $436.52 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $162.18 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $141.25 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $141.25 |
CareSource Setting Facility Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Facility | None | $977.24 | $977.24 | $977.24 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $933.25 | Professional | None | $831.76 | $831.76 | $933.25 |
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 $741.31 Median $831.76 Typical High $1,258.93 | Professional | None | $741.31 | $831.76 | $1,258.93 |
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 $741.31 Median $831.76 Typical High $1,258.93 | Professional | None | $741.31 | $831.76 | $1,258.93 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $645.65 Typical High $1,000.00 | Professional | None | $64.57 | $645.65 | $1,000.00 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | None | $758.58 | $758.58 | $891.25 |
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 $616.60 Median $831.76 Typical High $1,258.93 | Professional | None | $616.60 | $831.76 | $1,258.93 |
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 $389.05 Median $389.05 Typical High $512.86 | Professional | 52 · Reduced service | $389.05 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $758.58 | Professional | 54 · Surgery only | $588.84 | $588.84 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $549.54 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $549.54 | $549.54 | $707.95 |
Where Ohio sits
The same service costs 6.1 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 $8,436MD $1,394
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.