How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $2,089 · 10th to 90th $1,549 to $3,162
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 $1,513.56 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,548.82 | $2,041.74 |
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 $1,737.80 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,737.80 | $2,290.87 | $3,235.94 |
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 $1,548.82 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,548.82 | $1,949.84 | $2,754.23 |
Denver HMP Setting Facility Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $3,630.78 | Facility | None | $1,548.82 | $1,949.84 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,995.26 | $3,162.28 |
Select Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,884.03 Typical High $3,019.95 | Facility | None | $1,445.44 | $2,884.03 | $3,019.95 |
Select Health Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,513.56 | $2,290.87 |
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 $1,548.82 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,548.82 | $1,949.84 | $3,090.30 |
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 $758.58 Median $776.25 Typical High $933.25 | Professional | 52 · Reduced service | $758.58 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $371.54 | Professional | 53 · Discontinued | $302.00 | $309.03 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,174.90 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $234.42 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $154.88 Typical High $186.21 | Professional | 56 · Pre-op care only | $151.36 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,096.48 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,096.48 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $977.24 Typical High $1,584.89 | Professional | 62 · Two surgeons | $758.58 | $977.24 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $245.47 Typical High $398.11 | Professional | 80 · Assistant surgeon | $190.55 | $245.47 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $213.80 Typical High $346.74 | Professional | AS · PA/NP assist | $165.96 | $213.80 | $346.74 |
Where Colorado sits
The same service costs 8.2 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 $17,891MD $2,184
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.