How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $2,188 · 10th to 90th $1,445 to $3,548
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 $1,548.82 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,548.82 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,548.82 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $8,128.31 | Facility | None | $588.84 | $1,862.09 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,288.25 | $2,187.76 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,445.44 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,047.13 | $1,445.44 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $398.11 Typical High $630.96 | Professional | 80 · Assistant surgeon | $257.04 | $398.11 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $309.03 Typical High $549.54 | Professional | AS · PA/NP assist | $229.09 | $309.03 | $549.54 |
CareSource Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,454.71 Typical High $4,897.79 | Professional | None | $1,698.24 | $2,454.71 | $4,897.79 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,737.80 | $2,041.74 | $3,162.28 |
Oscar Health Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,511.89 Typical High $5,011.87 | Professional | None | $1,412.54 | $2,511.89 | $5,011.87 |
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 $776.25 Median $776.25 Typical High $1,000.00 | Professional | 52 · Reduced service | $776.25 | $776.25 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $407.38 | Professional | 53 · Discontinued | $309.03 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,412.54 |
Where Georgia 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.