How much rates vary
Facilitymedian $3,715 · 10th to 90th $501 to $16,596Professionalmedian $1,259 · 10th to 90th $138 to $1,905
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 $10,232.93 Typical High $13,803.84 | Facility | None | $1,288.25 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $5,370.32 | Professional | None | $1,288.25 | $1,288.25 | $5,370.32 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $7,943.28 Typical High $19,952.62 | Facility | None | $1,047.13 | $7,943.28 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,258.93 | $2,137.96 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $1,122.02 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,412.54 | $2,630.27 |
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 $1,122.02 Median $1,412.54 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,412.54 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,202.26 Typical High $1,659.59 | Professional | None | $123.03 | $1,202.26 | $1,659.59 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,174.90 | $1,819.70 |
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 $1,202.26 Median $1,479.11 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,479.11 | $3,090.30 |
10 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 $630.96 Typical High $2,398.83 | Professional | 52 · Reduced service | $630.96 | $630.96 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $954.99 | Professional | 53 · Discontinued | $257.04 | $257.04 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $3,630.78 | Professional | 54 · Surgery only | $954.99 | $954.99 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $724.44 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $478.63 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,905.46 Typical High $3,162.28 | Professional | 50 · Both sides | $1,513.56 | $1,905.46 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $812.83 Typical High $1,348.96 | Professional | 62 · Two surgeons | $630.96 | $812.83 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $204.17 Typical High $346.74 | Professional | 80 · Assistant surgeon | $158.49 | $204.17 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $302.00 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $302.00 |
Where Ohio 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.