How much rates vary
Facilitymedian $1,288 · 10th to 90th $513 to $9,772Professionalmedian $1,820 · 10th to 90th $1,288 to $3,548
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 $1,348.96 Median $7,244.36 Typical High $15,488.17 | Facility | None | $1,348.96 | $7,244.36 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $3,630.78 | Professional | None | $1,348.96 | $1,584.89 | $3,630.78 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,288.25 | $1,584.89 | $2,238.72 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $363.08 Typical High $363.08 | Professional | 80 · Assistant surgeon | $208.93 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,691.53 Typical High $12,302.69 | Facility | None | $831.76 | $2,691.53 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,819.70 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,754.23 Typical High $4,897.79 | Professional | 50 · Both sides | $2,089.30 | $2,754.23 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,174.90 Typical High $2,041.74 | Professional | 62 · Two surgeons | $870.96 | $1,174.90 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $302.00 Typical High $524.81 | Professional | 80 · Assistant surgeon | $218.78 | $302.00 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $257.04 Typical High $457.09 | Professional | AS · PA/NP assist | $194.98 | $257.04 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $4,265.80 | Facility | None | $457.09 | $549.54 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $3,630.78 | Professional | None | $1,548.82 | $2,137.96 | $3,630.78 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,548.82 | $2,454.71 |
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 $1,380.38 Median $2,089.30 Typical High $4,073.80 | Professional | None | $1,380.38 | $2,089.30 | $4,073.80 |
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 $676.08 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $676.08 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $269.15 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $1,148.15 |
Where Georgia sits
The same service costs 14.0 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 $28,122MD $2,008
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.