How much rates vary
Facilitymedian $1,698 · 10th to 90th $457 to $9,772Professionalmedian $832 · 10th to 90th $692 to $1,318
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 $977.24 Median $977.24 Typical High $1,230.27 | Facility | None | $977.24 | $977.24 | $1,230.27 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,230.27 | Professional | None | $977.24 | $1,000.00 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,548.13 Median $6,025.60 Typical High $11,220.18 | Facility | None | $3,548.13 | $6,025.60 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $933.25 | Professional | None | $691.83 | $794.33 | $933.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $512.86 Typical High $776.25 | Professional | 62 · Two surgeons | $436.52 | $512.86 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $128.82 Typical High $147.91 | Professional | 80 · Assistant surgeon | $112.20 | $128.82 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $134.90 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $134.90 |
CareSource Setting Facility Modifier None Typical Low $794.33 Median $954.99 Typical High $1,479.11 | Facility | None | $794.33 | $954.99 | $1,479.11 |
CareSource Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,548.82 | Professional | None | $831.76 | $1,174.90 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,698.24 | Facility | None | $34.67 | $691.83 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $5,128.61 | Professional | None | $954.99 | $1,071.52 | $5,128.61 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,202.26 Typical High $1,513.56 | Professional | None | $870.96 | $1,202.26 | $1,513.56 |
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 $489.78 Median $501.19 Typical High $616.60 | Professional | 52 · Reduced service | $489.78 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $245.47 | Professional | 53 · Discontinued | $194.98 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $933.25 | Professional | 54 · Surgery only | $741.31 | $741.31 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $151.36 Typical High $186.21 | Professional | 55 · Aftercare only | $147.91 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $123.03 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $870.96 |
Where Kentucky sits
The same service costs 10.6 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 $17,137MD $1,609
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.