How much rates vary
Facilitymedian $4,074 · 10th to 90th $550 to $19,055Professionalmedian $1,175 · 10th to 90th $138 to $1,778
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 $2,187.76 Median $6,025.60 Typical High $12,589.25 | Facility | None | $2,187.76 | $6,025.60 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $9,332.54 | Professional | None | $1,202.26 | $1,380.38 | $9,332.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $9,549.93 Typical High $22,908.68 | Facility | None | $1,148.15 | $9,549.93 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,819.70 | Professional | None | $933.25 | $1,096.48 | $1,819.70 |
CareSource Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Facility | None | $1,479.11 | $1,479.11 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,318.26 | $2,454.71 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,318.26 | $2,454.71 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,122.02 Typical High $1,584.89 | Professional | None | $123.03 | $1,122.02 | $1,584.89 |
SummaCare Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,122.02 | $1,698.24 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $5,248.07 | Facility | None | $371.54 | $977.24 | $5,248.07 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,884.03 | Professional | None | $1,122.02 | $1,380.38 | $2,884.03 |
10 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 $602.56 Typical High $2,089.30 | Professional | 52 · Reduced service | $602.56 | $602.56 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $831.76 | Professional | 53 · Discontinued | $239.88 | $239.88 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $3,090.30 | Professional | 54 · Surgery only | $891.25 | $891.25 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $630.96 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $416.87 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,412.54 Median $1,659.59 Typical High $2,691.53 | Professional | 50 · Both sides | $1,412.54 | $1,659.59 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $691.83 Typical High $1,148.15 | Professional | 62 · Two surgeons | $588.84 | $691.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $177.83 Typical High $288.40 | Professional | 80 · Assistant surgeon | $151.36 | $177.83 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $154.88 Typical High $257.04 | Professional | AS · PA/NP assist | $131.83 | $154.88 | $257.04 |
Where Ohio 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.