How much rates vary
Facilitymedian $2,630 · 10th to 90th $457 to $9,772Professionalmedian $1,778 · 10th to 90th $1,479 to $2,818
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 $2,089.30 Median $2,187.76 Typical High $2,630.27 | Facility | None | $2,089.30 | $2,187.76 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,137.96 Typical High $2,630.27 | Professional | None | $2,089.30 | $2,137.96 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $11,220.18 | Facility | None | $3,548.13 | $6,025.60 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,698.24 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,071.52 Typical High $1,230.27 | Professional | 62 · Two surgeons | $912.01 | $1,071.52 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $309.03 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $269.15 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $3,162.28 | Facility | None | $1,698.24 | $2,041.74 | $3,162.28 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,344.23 | $3,162.28 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,548.13 | Facility | None | $34.67 | $512.86 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $11,220.18 | Professional | None | $2,041.74 | $2,290.87 | $11,220.18 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,630.27 Typical High $3,311.31 | Professional | None | $1,905.46 | $2,630.27 | $3,311.31 |
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 $1,047.13 Median $1,071.52 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,047.13 | $1,071.52 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $426.58 Typical High $524.81 | Professional | 53 · Discontinued | $416.87 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,621.81 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,548.82 | $1,621.81 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $323.59 Typical High $398.11 | Professional | 55 · Aftercare only | $316.23 | $323.59 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $213.80 Typical High $263.03 | Professional | 56 · Pre-op care only | $208.93 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,513.56 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,513.56 | $1,862.09 |
Where Kentucky 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.