How much rates vary
Facilitymedian $955 · 10th to 90th $501 to $6,607Professionalmedian $1,738 · 10th to 90th $1,148 to $2,951
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 $5,370.32 Typical High $7,943.28 | Facility | None | $1,288.25 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,862.09 Typical High $7,943.28 | Facility | None | $588.84 | $1,862.09 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,122.02 | $1,737.80 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,096.48 Typical High $1,778.28 | Professional | 62 · Two surgeons | $794.33 | $1,096.48 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $275.42 Typical High $478.63 | Professional | 80 · Assistant surgeon | $199.53 | $275.42 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $239.88 Typical High $407.38 | Professional | AS · PA/NP assist | $173.78 | $239.88 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,398.83 | Facility | None | $457.09 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $3,467.37 | Professional | None | $1,412.54 | $1,949.84 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,445.44 | $2,344.23 |
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 $1,288.25 Median $1,905.46 Typical High $3,890.45 | Professional | None | $1,288.25 | $1,905.46 | $3,890.45 |
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 $630.96 Median $630.96 Typical High $758.58 | Professional | 52 · Reduced service | $630.96 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | 53 · Discontinued | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 56 · Pre-op care only | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,071.52 |
Where Georgia sits
The same service costs 9.0 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 $17,266MD $1,911
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.