How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $2,630 · 10th to 90th $1,995 to $3,981
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 $1,949.84 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,949.84 | $1,995.26 | $2,570.40 |
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 $2,187.76 Median $2,951.21 Typical High $4,168.69 | Professional | None | $2,187.76 | $2,951.21 | $4,168.69 |
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 $1,995.26 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,511.89 | $3,548.13 |
Denver HMP Setting Facility Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $4,570.88 | Facility | None | $1,995.26 | $2,511.89 | $4,570.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $4,073.80 | Professional | None | $1,995.26 | $2,570.40 | $4,073.80 |
Select Health Setting Facility Modifier None Typical Low $1,819.70 Median $3,630.78 Typical High $3,890.45 | Facility | None | $1,819.70 | $3,630.78 | $3,890.45 |
Select Health Setting Professional Modifier None Typical Low $1,659.59 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,659.59 | $1,949.84 | $2,951.21 |
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 $1,995.26 Median $2,511.89 Typical High $3,981.07 | Professional | None | $1,995.26 | $2,511.89 | $3,981.07 |
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 $977.24 Median $1,000.00 Typical High $1,174.90 | Professional | 52 · Reduced service | $977.24 | $1,000.00 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $398.11 Typical High $467.74 | Professional | 53 · Discontinued | $389.05 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $199.53 Typical High $234.42 | Professional | 56 · Pre-op care only | $194.98 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,202.26 Typical High $1,995.26 | Professional | 62 · Two surgeons | $977.24 | $1,202.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $309.03 Typical High $512.86 | Professional | 80 · Assistant surgeon | $245.47 | $309.03 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $269.15 Typical High $446.68 | Professional | AS · PA/NP assist | $213.80 | $269.15 | $446.68 |
Where Colorado sits
The same service costs 6.9 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 $18,419MD $2,652
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.