How much rates vary
Facilitymedian $6,310 · 10th to 90th $933 to $12,589Professionalmedian $1,023 · 10th to 90th $776 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 $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 $741.31 Median $776.25 Typical High $1,000.00 | Professional | None | $741.31 | $776.25 | $1,000.00 |
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 $851.14 Median $1,148.15 Typical High $1,584.89 | Professional | None | $851.14 | $1,148.15 | $1,584.89 |
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 $776.25 Median $933.25 Typical High $1,380.38 | Professional | None | $776.25 | $933.25 | $1,380.38 |
Denver HMP Setting Facility Modifier None Typical Low $776.25 Median $954.99 Typical High $1,819.70 | Facility | None | $776.25 | $954.99 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,621.81 | Professional | None | $794.33 | $1,023.29 | $1,621.81 |
Select Health Setting Facility Modifier None Typical Low $724.44 Median $1,445.44 Typical High $1,548.82 | Facility | None | $724.44 | $1,445.44 | $1,548.82 |
Select Health Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $1,174.90 | Professional | None | $645.65 | $758.58 | $1,174.90 |
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 $741.31 Median $954.99 Typical High $1,548.82 | Professional | None | $741.31 | $954.99 | $1,548.82 |
9 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 $371.54 Median $389.05 Typical High $457.09 | Professional | 52 · Reduced service | $371.54 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $154.88 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $588.84 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $91.20 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $549.54 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $549.54 | $630.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $478.63 Typical High $870.96 | Professional | 62 · Two surgeons | $380.19 | $478.63 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $120.23 Typical High $204.17 | Professional | 80 · Assistant surgeon | $97.72 | $120.23 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $107.15 Typical High $177.83 | Professional | AS · PA/NP assist | $85.11 | $107.15 | $177.83 |
Where Colorado sits
The same service costs 12.3 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 $16,849MD $1,375
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.