How much rates vary
Facilitymedian $955 · 10th to 90th $501 to $6,761Professionalmedian $1,072 · 10th to 90th $724 to $1,950
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 $776.25 Median $5,370.32 Typical High $7,943.28 | Facility | None | $776.25 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,000.00 | Professional | None | $776.25 | $776.25 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $8,128.31 | Facility | None | $588.84 | $1,862.09 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,819.70 | Professional | None | $645.65 | $1,071.52 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $707.95 Typical High $1,230.27 | Professional | 62 · Two surgeons | $512.86 | $707.95 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $194.98 Typical High $316.23 | Professional | 80 · Assistant surgeon | $125.89 | $194.98 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $154.88 Typical High $275.42 | Professional | AS · PA/NP assist | $114.82 | $154.88 | $275.42 |
CareSource Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $2,187.76 | Professional | None | $812.83 | $1,202.26 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,621.81 | Professional | None | $870.96 | $1,023.29 | $1,621.81 |
Oscar Health Setting Professional Modifier None Typical Low $831.76 Median $1,380.38 Typical High $1,819.70 | Professional | None | $831.76 | $1,380.38 | $1,819.70 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,258.93 Typical High $2,511.89 | Professional | None | $707.95 | $1,258.93 | $2,511.89 |
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 $380.19 Median $380.19 Typical High $501.19 | Professional | 52 · Reduced service | $380.19 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $154.88 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $758.58 | Professional | 54 · Surgery only | $575.44 | $575.44 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $151.36 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $100.00 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $707.95 |
Where Georgia 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.