How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $1,479 · 10th to 90th $1,122 to $2,239
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 $1,071.52 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,122.02 | $1,445.44 |
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 $1,230.27 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,659.59 | $2,290.87 |
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 $1,096.48 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,380.38 | $1,949.84 |
Denver HMP Setting Facility Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,570.40 | Facility | None | $1,122.02 | $1,380.38 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,445.44 | $2,290.87 |
Select Health Setting Facility Modifier None Typical Low $1,047.13 Median $2,089.30 Typical High $2,187.76 | Facility | None | $1,047.13 | $2,089.30 | $2,187.76 |
Select Health Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,659.59 | Professional | None | $912.01 | $1,096.48 | $1,659.59 |
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 $1,096.48 Median $1,380.38 Typical High $2,238.72 | Professional | None | $1,096.48 | $1,380.38 | $2,238.72 |
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 $537.03 Median $562.34 Typical High $660.69 | Professional | 52 · Reduced service | $537.03 | $562.34 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $223.87 Typical High $263.03 | Professional | 53 · Discontinued | $218.78 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $831.76 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $165.96 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $107.15 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $776.25 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $776.25 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $707.95 Typical High $1,148.15 | Professional | 62 · Two surgeons | $537.03 | $707.95 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $177.83 Typical High $288.40 | Professional | 80 · Assistant surgeon | $134.90 | $177.83 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $151.36 Typical High $251.19 | Professional | AS · PA/NP assist | $117.49 | $151.36 | $251.19 |
Where Colorado sits
The same service costs 10.0 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 $17,294MD $1,737
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.