How much rates vary
Facilitymedian $1,479 · 10th to 90th $457 to $9,772Professionalmedian $832 · 10th to 90th $646 to $1,202
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 $870.96 Median $891.25 Typical High $1,096.48 | Facility | None | $870.96 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $1,096.48 | Professional | None | $870.96 | $891.25 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $11,220.18 | Facility | None | $3,548.13 | $6,025.60 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $977.24 | Professional | None | $630.96 | $776.25 | $977.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $489.78 Typical High $602.56 | Professional | 62 · Two surgeons | $398.11 | $489.78 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $123.03 Typical High $154.88 | Professional | 80 · Assistant surgeon | $102.33 | $123.03 | $154.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $107.15 Typical High $134.90 | Professional | AS · PA/NP assist | $89.13 | $107.15 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $691.83 Median $831.76 Typical High $1,318.26 | Facility | None | $691.83 | $831.76 | $1,318.26 |
CareSource Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,318.26 | Professional | None | $741.31 | $1,023.29 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,479.11 | Facility | None | $34.67 | $691.83 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $4,677.35 | Professional | None | $851.14 | $933.25 | $4,677.35 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,348.96 | Professional | None | $794.33 | $1,071.52 | $1,348.96 |
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 $436.52 Median $446.68 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $177.83 Typical High $218.78 | Professional | 53 · Discontinued | $173.78 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $660.69 Typical High $812.83 | Professional | 54 · Surgery only | $645.65 | $660.69 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $131.83 Typical High $165.96 | Professional | 55 · Aftercare only | $128.82 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $109.65 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $616.60 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $616.60 | $758.58 |
Where Kentucky sits
The same service costs 11.4 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 $16,997MD $1,496
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.