How much rates vary
Facilitymedian $1,096 · 10th to 90th $513 to $7,943Professionalmedian $1,413 · 10th to 90th $955 to $2,455
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 $1,047.13 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,047.13 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,380.38 | Professional | None | $1,047.13 | $1,047.13 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $10,715.19 | Facility | None | $707.95 | $2,290.87 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $2,344.23 | Professional | None | $933.25 | $1,412.54 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,137.96 Typical High $3,548.13 | Professional | 50 · Both sides | $1,548.82 | $2,137.96 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $891.25 Typical High $1,479.11 | Professional | 62 · Two surgeons | $660.69 | $891.25 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $229.09 Typical High $389.05 | Professional | 80 · Assistant surgeon | $165.96 | $229.09 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $199.53 Typical High $331.13 | Professional | AS · PA/NP assist | $144.54 | $199.53 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,621.81 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,905.46 | Professional | None | $954.99 | $1,202.26 | $1,905.46 |
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 $1,071.52 Median $1,548.82 Typical High $3,162.28 | Professional | None | $1,071.52 | $1,548.82 | $3,162.28 |
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 $524.81 Median $524.81 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 53 · Discontinued | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $933.25 | Professional | 54 · Surgery only | $794.33 | $794.33 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $870.96 |
Where Georgia sits
The same service costs 14.5 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 $24,354MD $1,684
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.