How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,913Professionalmedian $1,000 · 10th to 90th $832 to $6,457
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 $1,047.13 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,047.13 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,000.00 | Professional | None | $812.83 | $870.96 | $1,000.00 |
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 $812.83 Median $977.24 Typical High $1,412.54 | Professional | None | $812.83 | $977.24 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $616.60 Typical High $891.25 | Professional | 62 · Two surgeons | $512.86 | $616.60 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $154.88 Typical High $229.09 | Professional | 80 · Assistant surgeon | $128.82 | $154.88 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $134.90 Typical High $199.53 | Professional | AS · PA/NP assist | $112.20 | $134.90 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,318.26 | Professional | None | $851.14 | $933.25 | $1,318.26 |
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 $851.14 Median $977.24 Typical High $1,778.28 | Professional | None | $851.14 | $977.24 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $8,317.64 | Facility | None | $54.95 | $1,230.27 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $6,456.54 Typical High $6,456.54 | Professional | None | $1,047.13 | $6,456.54 | $6,456.54 |
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 $831.76 Median $1,202.26 Typical High $2,137.96 | Professional | None | $831.76 | $1,202.26 | $2,137.96 |
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 $407.38 Median $436.52 Typical High $501.19 | Professional | 52 · Reduced service | $407.38 | $436.52 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $691.83 |
Where Missouri 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.