How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $1,862 · 10th to 90th $1,479 to $11,220
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,737.80 | Professional | None | $1,445.44 | $1,548.82 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,862.09 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,174.90 Typical High $1,584.89 | Professional | 62 · Two surgeons | $933.25 | $1,174.90 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $295.12 Typical High $407.38 | Professional | 80 · Assistant surgeon | $239.88 | $295.12 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $257.04 Typical High $354.81 | Professional | AS · PA/NP assist | $208.93 | $257.04 | $354.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,479.11 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,479.11 | $1,621.81 | $2,290.87 |
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 $1,479.11 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,479.11 | $1,698.24 | $3,090.30 |
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 $1,862.09 Median $11,220.18 Typical High $11,220.18 | Professional | None | $1,862.09 | $11,220.18 | $11,220.18 |
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 $1,479.11 Median $2,137.96 Typical High $3,801.89 | Professional | None | $1,479.11 | $2,137.96 | $3,801.89 |
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 $724.44 Median $758.58 Typical High $870.96 | Professional | 52 · Reduced service | $724.44 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $346.74 | Professional | 53 · Discontinued | $288.40 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $173.78 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,230.27 |
Where Missouri 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.