How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $2,455 · 10th to 90th $1,698 to $15,488
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 $1,995.26 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,995.26 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,137.96 Typical High $2,398.83 | Professional | None | $1,995.26 | $2,137.96 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $3,981.07 Typical High $10,471.29 | Facility | None | $1,513.56 | $3,981.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,235.94 | Professional | None | $1,698.24 | $2,344.23 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,479.11 Typical High $2,041.74 | Professional | 62 · Two surgeons | $1,071.52 | $1,479.11 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $380.19 Typical High $524.81 | Professional | 80 · Assistant surgeon | $269.15 | $380.19 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $331.13 Typical High $457.09 | Professional | AS · PA/NP assist | $234.42 | $331.13 | $457.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $3,090.30 | Professional | None | $2,041.74 | $2,238.72 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,344.23 Typical High $4,265.80 | Professional | None | $2,041.74 | $2,344.23 | $4,265.80 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $2,570.40 Median $15,488.17 Typical High $15,488.17 | Professional | None | $2,570.40 | $15,488.17 | $15,488.17 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,951.21 Typical High $5,128.61 | Professional | None | $2,041.74 | $2,951.21 | $5,128.61 |
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 $1,000.00 Median $1,047.13 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,000.00 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $416.87 Typical High $478.63 | Professional | 53 · Discontinued | $398.11 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,584.89 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,479.11 | $1,584.89 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $316.23 Typical High $363.08 | Professional | 55 · Aftercare only | $295.12 | $316.23 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $208.93 Typical High $239.88 | Professional | 56 · Pre-op care only | $199.53 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,479.11 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,479.11 | $1,698.24 |
Where Missouri 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.