How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $7,943Professionalmedian $1,778 · 10th to 90th $1,202 to $3,388
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 $1,288.25 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,288.25 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $3,548.13 | Professional | None | $1,288.25 | $1,479.11 | $3,548.13 |
Ambetter Setting Professional Modifier None Typical Low $1,698.24 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,698.24 | $2,630.27 | $2,630.27 |
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 $1,202.26 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,778.28 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,630.27 Typical High $4,365.16 | Professional | 50 · Both sides | $1,995.26 | $2,630.27 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,122.02 Typical High $1,862.09 | Professional | 62 · Two surgeons | $831.76 | $1,122.02 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $288.40 Typical High $489.78 | Professional | 80 · Assistant surgeon | $208.93 | $288.40 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $245.47 Typical High $416.87 | Professional | AS · PA/NP assist | $186.21 | $245.47 | $416.87 |
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 $1,479.11 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,479.11 | $2,041.74 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $4,365.16 | Professional | None | $1,174.90 | $1,479.11 | $4,365.16 |
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 $1,318.26 Median $1,949.84 Typical High $3,981.07 | Professional | None | $1,318.26 | $1,949.84 | $3,981.07 |
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 $645.65 Median $645.65 Typical High $776.25 | Professional | 52 · Reduced service | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 53 · Discontinued | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $912.01 | $912.01 | $1,096.48 |
Where Georgia sits
The same service costs 12.5 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 $24,646MD $1,975
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.