How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $8,913Professionalmedian $1,349 · 10th to 90th $977 to $2,692
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 $1,096.48 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,096.48 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,412.54 | Professional | None | $870.96 | $1,122.02 | $1,412.54 |
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 $1,023.29 Median $1,318.26 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,318.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $831.76 Typical High $1,174.90 | Professional | 62 · Two surgeons | $645.65 | $831.76 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $208.93 Typical High $302.00 | Professional | 80 · Assistant surgeon | $162.18 | $208.93 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $181.97 Typical High $263.03 | Professional | AS · PA/NP assist | $141.25 | $181.97 | $263.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,348.96 | Professional | None | $891.25 | $977.24 | $1,348.96 |
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 $977.24 Median $1,096.48 Typical High $2,187.76 | Professional | None | $977.24 | $1,096.48 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $7,762.47 | Facility | None | $54.95 | $1,230.27 | $7,762.47 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $2,187.76 Typical High $20,417.38 | Professional | None | $1,174.90 | $2,187.76 | $20,417.38 |
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 $1,023.29 Median $1,445.44 Typical High $2,511.89 | Professional | None | $1,023.29 | $1,445.44 | $2,511.89 |
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 $436.52 Median $549.54 Typical High $562.34 | Professional | 52 · Reduced service | $436.52 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $218.78 Typical High $223.87 | Professional | 53 · Discontinued | $177.83 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $831.76 Typical High $851.14 | Professional | 54 · Surgery only | $660.69 | $831.76 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $165.96 Typical High $169.82 | Professional | 55 · Aftercare only | $131.83 | $165.96 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $109.65 Typical High $112.20 | Professional | 56 · Pre-op care only | $87.10 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $776.25 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $616.60 | $776.25 | $794.33 |
Where Missouri sits
The same service costs 10.3 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 $16,837MD $1,634
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.