How much rates vary
Facilitymedian $4,571 · 10th to 90th $537 to $19,055Professionalmedian $1,349 · 10th to 90th $138 to $1,995
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 $3,715.35 Median $9,120.11 Typical High $12,589.25 | Facility | None | $3,715.35 | $9,120.11 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $9,332.54 | Professional | None | $1,348.96 | $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 $1,071.52 Median $1,258.93 Typical High $2,041.74 | Professional | None | $1,071.52 | $1,258.93 | $2,041.74 |
CareSource Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $1,174.90 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,479.11 | $2,754.23 |
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 $1,174.90 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,479.11 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,258.93 Typical High $1,778.28 | Professional | None | $123.03 | $1,258.93 | $1,778.28 |
SummaCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,949.84 | Professional | None | $1,230.27 | $1,230.27 | $1,949.84 |
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 $1,258.93 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,258.93 | $1,584.89 | $3,235.94 |
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 $660.69 Median $660.69 Typical High $2,398.83 | Professional | 52 · Reduced service | $660.69 | $660.69 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $954.99 | Professional | 53 · Discontinued | $269.15 | $269.15 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $3,548.13 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $724.44 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $478.63 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,905.46 Typical High $3,019.95 | Professional | 50 · Both sides | $1,621.81 | $1,905.46 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $1,318.26 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $199.53 Typical High $338.84 | Professional | 80 · Assistant surgeon | $169.82 | $199.53 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $288.40 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $288.40 |
Where Ohio sits
The same service costs 13.9 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 $28,165MD $2,021
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.