How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $12,589Professionalmedian $1,023 · 10th to 90th $138 to $1,549
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 $1,122.02 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,122.02 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $3,715.35 | Professional | None | $1,122.02 | $1,122.02 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,803.84 | Facility | None | $891.25 | $6,606.93 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,479.11 | Professional | None | $851.14 | $1,000.00 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $630.96 Typical High $933.25 | Professional | 62 · Two surgeons | $537.03 | $630.96 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $162.18 Typical High $239.88 | Professional | 80 · Assistant surgeon | $138.04 | $162.18 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $141.25 Typical High $208.93 | Professional | AS · PA/NP assist | $120.23 | $141.25 | $208.93 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
CareSource Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,174.90 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,174.90 | $1,862.09 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,071.52 | $1,174.90 | $1,862.09 |
Molina Setting Professional Modifier None Typical Low $97.72 Median $912.01 Typical High $1,445.44 | Professional | None | $97.72 | $912.01 | $1,445.44 |
SummaCare Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,071.52 | $1,258.93 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $1,778.28 | Professional | None | $891.25 | $1,174.90 | $1,778.28 |
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 $549.54 Median $549.54 Typical High $724.44 | Professional | 52 · Reduced service | $549.54 | $549.54 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $288.40 | Professional | 53 · Discontinued | $223.87 | $223.87 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $144.54 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,023.29 |
Where Ohio 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.