How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $2,818 · 10th to 90th $1,862 to $5,012
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 $5,370.32 Typical High $7,943.28 | Facility | None | $1,995.26 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,995.26 | $1,995.26 | $2,630.27 |
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 $1,659.59 Median $2,818.38 Typical High $4,786.30 | Professional | None | $1,659.59 | $2,818.38 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,862.09 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,348.96 | $1,862.09 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $512.86 Typical High $812.83 | Professional | 80 · Assistant surgeon | $331.13 | $512.86 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $389.05 Typical High $707.95 | Professional | AS · PA/NP assist | $288.40 | $389.05 | $707.95 |
CareSource Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $2,187.76 Median $3,162.28 Typical High $6,165.95 | Professional | None | $2,187.76 | $3,162.28 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,630.27 | $3,548.13 |
Oscar Health Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
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 $1,819.70 Median $3,235.94 Typical High $6,456.54 | Professional | None | $1,819.70 | $3,235.94 | $6,456.54 |
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 $1,000.00 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $524.81 | Professional | 53 · Discontinued | $398.11 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $389.05 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $257.04 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,819.70 |
Where Georgia 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.