How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $11,220Professionalmedian $1,380 · 10th to 90th $1,072 to $2,138
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 $1,318.26 Median $1,513.56 Typical High $1,621.81 | Facility | None | $1,318.26 | $1,513.56 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,318.26 Typical High $1,737.80 | Professional | None | $1,258.93 | $1,318.26 | $1,737.80 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $1,380.38 | Professional | None | $223.87 | $223.87 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $8,709.64 Typical High $14,125.38 | Facility | None | $5,128.61 | $8,709.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,380.38 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,089.30 Typical High $2,884.03 | Professional | 50 · Both sides | $1,621.81 | $2,089.30 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $870.96 Typical High $1,202.26 | Professional | 62 · Two surgeons | $676.08 | $870.96 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $223.87 Typical High $309.03 | Professional | 80 · Assistant surgeon | $173.78 | $223.87 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $194.98 Typical High $269.15 | Professional | AS · PA/NP assist | $151.36 | $194.98 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,905.46 | Facility | None | $1,000.00 | $1,202.26 | $1,905.46 |
CareSource Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,659.59 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $2,041.74 | Facility | None | $34.67 | $691.83 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,862.09 Typical High $11,748.98 | Professional | None | $1,202.26 | $1,862.09 | $11,748.98 |
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 $1,174.90 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,698.24 | $2,344.23 |
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 $630.96 Median $660.69 Typical High $831.76 | Professional | 52 · Reduced service | $630.96 | $660.69 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $263.03 Typical High $338.84 | Professional | 53 · Discontinued | $251.19 | $263.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $977.24 Typical High $1,258.93 | Professional | 54 · Surgery only | $933.25 | $977.24 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $194.98 Typical High $251.19 | Professional | 55 · Aftercare only | $186.21 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $131.83 Typical High $165.96 | Professional | 56 · Pre-op care only | $125.89 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $912.01 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $870.96 | $912.01 | $1,174.90 |
Where Kentucky 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.