How much rates vary
Facilitymedian $6,310 · 10th to 90th $1,000 to $12,589Professionalmedian $2,089 · 10th to 90th $1,585 to $3,236
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 $1,479.11 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,479.11 | $1,584.89 | $2,290.87 |
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 $1,778.28 Median $2,344.23 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,344.23 | $3,311.31 |
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 $1,548.82 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,995.26 | $2,818.38 |
Denver HMP Setting Facility Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $3,715.35 | Facility | None | $1,445.44 | $1,995.26 | $3,715.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,041.74 | $3,235.94 |
Select Health Setting Facility Modifier None Typical Low $1,479.11 Median $2,951.21 Typical High $3,090.30 | Facility | None | $1,479.11 | $2,951.21 | $3,090.30 |
Select Health Setting Professional Modifier None Typical Low $1,318.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,548.82 | $2,344.23 |
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 $1,584.89 Median $1,995.26 Typical High $3,162.28 | Professional | None | $1,584.89 | $1,995.26 | $3,162.28 |
8 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 $776.25 Median $794.33 Typical High $933.25 | Professional | 52 · Reduced service | $776.25 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $380.19 | Professional | 53 · Discontinued | $309.03 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,202.26 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,174.90 | $1,202.26 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $239.88 Typical High $281.84 | Professional | 55 · Aftercare only | $234.42 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $158.49 Typical High $190.55 | Professional | 56 · Pre-op care only | $154.88 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,122.02 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,122.02 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $257.04 Typical High $407.38 | Professional | 80 · Assistant surgeon | $190.55 | $257.04 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $223.87 Typical High $338.84 | Professional | AS · PA/NP assist | $165.96 | $223.87 | $338.84 |
Where Colorado sits
The same service costs 8.1 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 $17,891MD $2,222
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.