How much rates vary
Facilitymedian $3,311 · 10th to 90th $646 to $10,965Professionalmedian $1,622 · 10th to 90th $1,202 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 $2,511.89 Median $6,309.57 Typical High $10,715.19 | Facility | None | $2,511.89 | $6,309.57 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $3,311.31 | Professional | None | $1,096.48 | $1,380.38 | $3,311.31 |
Ambetter Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $1,659.59 | Professional | None | $223.87 | $223.87 | $1,659.59 |
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 $1,202.26 Median $1,621.81 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,621.81 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,454.71 Typical High $3,548.13 | Professional | 50 · Both sides | $1,819.70 | $2,454.71 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,023.29 Typical High $1,479.11 | Professional | 62 · Two surgeons | $758.58 | $1,023.29 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $263.03 Typical High $380.19 | Professional | 80 · Assistant surgeon | $194.98 | $263.03 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $229.09 Typical High $331.13 | Professional | AS · PA/NP assist | $169.82 | $229.09 | $331.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,202.26 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $741.31 Typical High $2,691.53 | Facility | None | $501.19 | $741.31 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,380.38 | $2,754.23 |
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 $1,479.11 Median $2,754.23 Typical High $8,912.51 | Professional | None | $1,479.11 | $2,754.23 | $8,912.51 |
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 $1,288.25 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,288.25 | $1,819.70 | $3,162.28 |
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 $549.54 Median $691.83 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $275.42 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $275.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,047.13 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $208.93 Typical High $213.80 | Professional | 55 · Aftercare only | $165.96 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $138.04 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $977.24 |
Where Missouri 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.