How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $12,589Professionalmedian $1,514 · 10th to 90th $155 to $2,188
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 $1,659.59 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,659.59 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $5,370.32 | Professional | None | $1,659.59 | $1,659.59 | $5,370.32 |
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 $1,288.25 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,513.56 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $954.99 Typical High $1,380.38 | Professional | 62 · Two surgeons | $812.83 | $954.99 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $239.88 Typical High $354.81 | Professional | 80 · Assistant surgeon | $204.17 | $239.88 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $309.03 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Facility | None | $2,089.30 | $2,089.30 | $2,089.30 |
CareSource Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,995.26 | Professional | None | $1,778.28 | $1,778.28 | $1,995.26 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,778.28 | $2,818.38 |
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 $1,584.89 Median $1,778.28 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,778.28 | $2,818.38 |
Molina Setting Professional Modifier None Typical Low $134.90 Median $1,202.26 Typical High $2,041.74 | Professional | None | $134.90 | $1,202.26 | $2,041.74 |
SummaCare Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,862.09 | Professional | None | $1,584.89 | $1,584.89 | $1,862.09 |
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 $1,348.96 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,348.96 | $1,778.28 | $2,691.53 |
2 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 54 · Surgery only Typical Low $1,258.93 Median $1,258.93 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,258.93 | $1,258.93 | $1,659.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,174.90 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,174.90 | $1,548.82 |
Where Ohio sits
The same service costs 8.0 times more in Maine than in Texas. 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 $18,037TX $2,258
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.