How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $9,772Professionalmedian $1,413 · 10th to 90th $1,047 to $8,128
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 $1,318.26 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,318.26 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,096.48 | $1,258.93 |
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 $1,071.52 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $831.76 Typical High $1,148.15 | Professional | 62 · Two surgeons | $660.69 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $208.93 Typical High $288.40 | Professional | 80 · Assistant surgeon | $169.82 | $208.93 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $181.97 Typical High $251.19 | Professional | AS · PA/NP assist | $147.91 | $181.97 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,174.90 | $1,621.81 |
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 $1,071.52 Median $1,202.26 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,202.26 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $9,772.37 | Facility | None | $54.95 | $1,230.27 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $8,128.31 Typical High $8,128.31 | Professional | None | $1,318.26 | $8,128.31 | $8,128.31 |
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 $1,047.13 Median $1,513.56 Typical High $2,691.53 | Professional | None | $1,047.13 | $1,513.56 | $2,691.53 |
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 $512.86 Median $537.03 Typical High $630.96 | Professional | 52 · Reduced service | $512.86 | $537.03 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $251.19 | Professional | 53 · Discontinued | $204.17 | $218.78 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $812.83 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $125.89 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $870.96 |
Where Missouri 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.