How much rates vary
Facilitymedian $6,457 · 10th to 90th $1,000 to $12,589Professionalmedian $2,818 · 10th to 90th $2,138 to $4,365
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 $2,570.40 Median $5,495.41 Typical High $8,912.51 | Facility | None | $2,570.40 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $2,691.53 | Professional | None | $2,089.30 | $2,137.96 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,786.30 Median $7,244.36 Typical High $13,182.57 | Facility | None | $4,786.30 | $7,244.36 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $4,466.84 | Professional | None | $2,344.23 | $3,162.28 | $4,466.84 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $2,344.23 Typical High $4,786.30 | Facility | None | $676.08 | $2,344.23 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,691.53 | $3,715.35 |
Denver HMP Setting Facility Modifier None Typical Low $1,949.84 Median $2,691.53 Typical High $4,897.79 | Facility | None | $1,949.84 | $2,691.53 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $4,365.16 | Professional | None | $2,187.76 | $2,754.23 | $4,365.16 |
Select Health Setting Facility Modifier None Typical Low $1,949.84 Median $3,981.07 Typical High $4,168.69 | Facility | None | $1,949.84 | $3,981.07 | $4,168.69 |
Select Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,778.28 | $2,089.30 | $3,162.28 |
United Setting Facility Modifier None Typical Low $645.65 Median $1,380.38 Typical High $7,762.47 | Facility | None | $645.65 | $1,380.38 | $7,762.47 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $4,365.16 | Professional | None | $2,137.96 | $2,691.53 | $4,365.16 |
9 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 $1,047.13 Median $1,071.52 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,047.13 | $1,071.52 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $512.86 | Professional | 53 · Discontinued | $416.87 | $426.58 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,621.81 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,548.82 | $1,621.81 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $323.59 Typical High $380.19 | Professional | 55 · Aftercare only | $316.23 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $213.80 Typical High $257.04 | Professional | 56 · Pre-op care only | $208.93 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,513.56 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,513.56 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,258.93 Typical High $2,187.76 | Professional | 62 · Two surgeons | $933.25 | $1,258.93 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $316.23 Typical High $549.54 | Professional | 80 · Assistant surgeon | $239.88 | $316.23 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $275.42 Typical High $478.63 | Professional | AS · PA/NP assist | $208.93 | $275.42 | $478.63 |
Where Colorado sits
The same service costs 7.6 times more in Maine than in Texas. 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 $18,667TX $2,469
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.