How much rates vary
Facilitymedian $3,388 · 10th to 90th $490 to $12,589Professionalmedian $724 · 10th to 90th $91 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 $912.01 Median $10,232.93 Typical High $13,803.84 | Facility | None | $912.01 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $2,511.89 | Professional | None | $758.58 | $758.58 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,803.84 | Facility | None | $891.25 | $6,606.93 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,071.52 | Professional | None | $616.60 | $724.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $457.09 Typical High $676.08 | Professional | 62 · Two surgeons | $389.05 | $457.09 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $173.78 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $147.91 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $147.91 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
CareSource Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | None | $812.83 | $812.83 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,288.25 | Professional | None | $741.31 | $812.83 | $1,288.25 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,288.25 | Professional | None | $758.58 | $812.83 | $1,288.25 |
Molina Setting Professional Modifier None Typical Low $64.57 Median $645.65 Typical High $1,023.29 | Professional | None | $64.57 | $645.65 | $1,023.29 |
SummaCare Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | None | $758.58 | $758.58 | $870.96 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $1,230.27 | Professional | None | $630.96 | $812.83 | $1,230.27 |
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 $75.86 Median $75.86 Typical High $100.00 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $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 Ohio 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.