How much rates vary
Facilitymedian $4,169 · 10th to 90th $603 to $12,023Professionalmedian $741 · 10th to 90th $78 to $1,122
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 $1,000.00 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,000.00 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $9,120.11 | Professional | None | $758.58 | $758.58 | $9,120.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $6,606.93 Typical High $13,489.63 | Facility | None | $891.25 | $6,606.93 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,202.26 | Professional | None | $588.84 | $741.31 | $1,202.26 |
CareSource Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Facility | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,548.82 | Professional | None | $676.08 | $831.76 | $1,548.82 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,548.82 | Professional | None | $676.08 | $831.76 | $1,548.82 |
Molina Setting Professional Modifier None Typical Low $63.10 Median $691.83 Typical High $1,023.29 | Professional | None | $63.10 | $691.83 | $1,023.29 |
SummaCare Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $1,122.02 | Professional | None | $707.95 | $707.95 | $1,122.02 |
United Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $7,244.36 | Facility | None | $707.95 | $1,905.46 | $7,244.36 |
United Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,862.09 | Professional | None | $741.31 | $891.25 | $1,862.09 |
9 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 $380.19 Median $380.19 Typical High $1,513.56 | Professional | 52 · Reduced service | $380.19 | $380.19 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $602.56 | Professional | 53 · Discontinued | $154.88 | $154.88 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $2,238.72 | Professional | 54 · Surgery only | $575.44 | $575.44 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $457.09 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $302.00 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $457.09 Typical High $741.31 | Professional | 62 · Two surgeons | $371.54 | $457.09 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $117.49 Typical High $194.98 | Professional | 80 · Assistant surgeon | $95.50 | $117.49 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $102.33 Typical High $169.82 | Professional | AS · PA/NP assist | $83.18 | $102.33 | $169.82 |
Where Ohio sits
The same service costs 7.8 times more in Maine than in Massachusetts. 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 $16,585MA $2,122
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.