How much rates vary
Facilitymedian $3,162 · 10th to 90th $631 to $11,220Professionalmedian $1,905 · 10th to 90th $1,349 to $4,365
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 $1,548.82 Median $6,309.57 Typical High $12,589.25 | Facility | None | $1,548.82 | $6,309.57 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,548.82 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,548.82 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $1,819.70 Typical High $1,819.70 | Professional | None | $245.47 | $1,819.70 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $4,466.84 Typical High $12,589.25 | Facility | None | $1,412.54 | $4,466.84 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,905.46 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,818.38 Typical High $3,981.07 | Professional | 50 · Both sides | $2,041.74 | $2,818.38 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,202.26 Typical High $1,659.59 | Professional | 62 · Two surgeons | $870.96 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $302.00 Typical High $426.58 | Professional | 80 · Assistant surgeon | $218.78 | $302.00 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $263.03 Typical High $371.54 | Professional | AS · PA/NP assist | $190.55 | $263.03 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,202.26 | $1,318.26 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $741.31 Typical High $2,691.53 | Facility | None | $489.78 | $741.31 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,513.56 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $2,511.89 Typical High $10,964.78 | Facility | None | $562.34 | $2,511.89 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,621.81 Median $3,019.95 Typical High $10,964.78 | Professional | None | $1,621.81 | $3,019.95 | $10,964.78 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,412.54 | $2,041.74 | $3,548.13 |
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 $602.56 Median $758.58 Typical High $776.25 | Professional | 52 · Reduced service | $602.56 | $758.58 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $302.00 Typical High $309.03 | Professional | 53 · Discontinued | $245.47 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,148.15 Typical High $1,174.90 | Professional | 54 · Surgery only | $912.01 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $229.09 Typical High $234.42 | Professional | 55 · Aftercare only | $181.97 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $151.36 Typical High $154.88 | Professional | 56 · Pre-op care only | $123.03 | $151.36 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,071.52 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $851.14 | $1,071.52 | $1,096.48 |
Where Missouri 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.