How much rates vary
Facilitymedian $1,905 · 10th to 90th $468 to $11,220Professionalmedian $1,288 · 10th to 90th $1,000 to $2,042
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 $891.25 Median $1,348.96 Typical High $3,630.78 | Facility | None | $891.25 | $1,348.96 | $3,630.78 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,174.90 | $1,230.27 | $1,862.09 |
Ambetter Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $10,000.00 Typical High $16,218.10 | Facility | None | $5,888.44 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,905.46 Typical High $2,511.89 | Professional | 50 · Both sides | $1,513.56 | $1,905.46 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $794.33 Typical High $1,288.25 | Professional | 62 · Two surgeons | $630.96 | $794.33 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $269.15 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $234.42 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $234.42 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,778.28 | Facility | None | $954.99 | $1,148.15 | $1,778.28 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,202.26 | $1,548.82 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,905.46 | Facility | None | $34.67 | $691.83 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $6,918.31 | Professional | None | $1,148.15 | $1,737.80 | $6,918.31 |
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 $1,096.48 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,584.89 | $2,187.76 |
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 $588.84 Median $616.60 Typical High $794.33 | Professional | 52 · Reduced service | $588.84 | $616.60 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $245.47 Typical High $316.23 | Professional | 53 · Discontinued | $234.42 | $245.47 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $933.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $891.25 | $933.25 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $186.21 Typical High $234.42 | Professional | 55 · Aftercare only | $177.83 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $123.03 Typical High $158.49 | Professional | 56 · Pre-op care only | $117.49 | $123.03 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $870.96 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $831.76 | $870.96 | $1,096.48 |
Where Kentucky 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.