How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $9,772Professionalmedian $1,778 · 10th to 90th $1,259 to $3,311
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 $1,445.44 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,445.44 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,445.44 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,698.24 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,071.52 Typical High $1,479.11 | Professional | 62 · Two surgeons | $851.14 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $275.42 Typical High $371.54 | Professional | 80 · Assistant surgeon | $213.80 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $239.88 Typical High $323.59 | Professional | AS · PA/NP assist | $186.21 | $239.88 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,148.15 | $1,258.93 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,818.38 | Professional | None | $1,230.27 | $1,412.54 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $9,772.37 | Facility | None | $54.95 | $1,348.96 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $21,877.62 | Professional | None | $1,513.56 | $2,818.38 | $21,877.62 |
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 $1,318.26 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,318.26 | $1,905.46 | $3,311.31 |
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 $575.44 Median $724.44 Typical High $741.31 | Professional | 52 · Reduced service | $575.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $288.40 Typical High $295.12 | Professional | 53 · Discontinued | $229.09 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $1,071.52 Typical High $1,096.48 | Professional | 54 · Surgery only | $851.14 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $213.80 Typical High $218.78 | Professional | 55 · Aftercare only | $169.82 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $114.82 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $1,000.00 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $794.33 | $1,000.00 | $1,023.29 |
Where Missouri 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.