How much rates vary
Facilitymedian $1,288 · 10th to 90th $457 to $9,772Professionalmedian $741 · 10th to 90th $603 to $1,072
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 $741.31 Median $851.14 Typical High $954.99 | Facility | None | $741.31 | $851.14 | $954.99 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $954.99 | Professional | None | $741.31 | $758.58 | $954.99 |
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 $602.56 Median $724.44 Typical High $1,071.52 | Professional | None | $602.56 | $724.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $457.09 Typical High $707.95 | Professional | 62 · Two surgeons | $380.19 | $457.09 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $117.49 Typical High $169.82 | Professional | 80 · Assistant surgeon | $97.72 | $117.49 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $147.91 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $602.56 Median $724.44 Typical High $1,148.15 | Facility | None | $602.56 | $724.44 | $1,148.15 |
CareSource Setting Professional Modifier None Typical Low $707.95 Median $891.25 Typical High $1,148.15 | Professional | None | $707.95 | $891.25 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,288.25 | Facility | None | $34.67 | $512.86 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $831.76 Typical High $4,466.84 | Professional | None | $724.44 | $831.76 | $4,466.84 |
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 $691.83 Median $933.25 Typical High $1,148.15 | Professional | None | $691.83 | $933.25 | $1,148.15 |
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 $371.54 Median $380.19 Typical High $478.63 | Professional | 52 · Reduced service | $371.54 | $380.19 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $154.88 Typical High $190.55 | Professional | 53 · Discontinued | $151.36 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $575.44 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $114.82 Typical High $141.25 | Professional | 55 · Aftercare only | $112.20 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $75.86 Typical High $95.50 | Professional | 56 · Pre-op care only | $74.13 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $537.03 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $537.03 | $660.69 |
Where Kentucky 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.