How much rates vary
Facilitymedian $1,318 · 10th to 90th $525 to $9,772Professionalmedian $1,660 · 10th to 90th $1,096 to $3,236
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 $7,079.46 Typical High $15,488.17 | Facility | None | $1,288.25 | $7,079.46 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $3,311.31 | Professional | None | $1,230.27 | $1,412.54 | $3,311.31 |
Ambetter Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,071.52 Median $1,659.59 Typical High $2,818.38 | Professional | None | $1,071.52 | $1,659.59 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,511.89 Typical High $4,365.16 | Professional | 50 · Both sides | $1,819.70 | $2,511.89 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,047.13 Typical High $1,862.09 | Professional | 62 · Two surgeons | $758.58 | $1,047.13 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $269.15 Typical High $512.86 | Professional | 80 · Assistant surgeon | $190.55 | $269.15 | $512.86 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $234.42 Typical High $416.87 | Professional | AS · PA/NP assist | $169.82 | $234.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $4,265.80 | Facility | None | $501.19 | $549.54 | $4,265.80 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,380.38 | $1,905.46 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $2,884.03 | Professional | None | $1,096.48 | $1,380.38 | $2,884.03 |
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 $1,258.93 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,258.93 | $1,819.70 | $3,715.35 |
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 $616.60 Median $616.60 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $295.12 | Professional | 53 · Discontinued | $245.47 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | 54 · Surgery only | $912.01 | $912.01 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $147.91 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $1,023.29 |
Where Georgia sits
The same service costs 14.8 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 $28,001MD $1,894
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.