How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,913Professionalmedian $1,000 · 10th to 90th $724 to $5,623
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 $912.01 Median $4,897.79 Typical High $7,762.47 | Facility | None | $912.01 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $870.96 | Professional | None | $707.95 | $758.58 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $1,288.25 | Professional | None | $741.31 | $933.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $588.84 Typical High $812.83 | Professional | 62 · Two surgeons | $467.74 | $588.84 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $151.36 Typical High $204.17 | Professional | 80 · Assistant surgeon | $120.23 | $151.36 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $131.83 Typical High $177.83 | Professional | AS · PA/NP assist | $104.71 | $131.83 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,148.15 | Professional | None | $741.31 | $812.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,479.11 | Professional | None | $724.44 | $812.83 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $6,918.31 | Facility | None | $54.95 | $1,230.27 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $5,623.41 Typical High $5,623.41 | Professional | None | $912.01 | $5,623.41 | $5,623.41 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $1,862.09 | Professional | None | $724.44 | $1,023.29 | $1,862.09 |
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 $354.81 Median $371.54 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $147.91 Typical High $173.78 | Professional | 53 · Discontinued | $141.25 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $74.13 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $602.56 |
Where Missouri 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.