How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $2,089 · 10th to 90th $1,479 to $3,981
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,348.96 | $1,698.24 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,412.54 | $3,801.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,995.26 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,258.93 Typical High $1,819.70 | Professional | 62 · Two surgeons | $977.24 | $1,258.93 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $323.59 Typical High $467.74 | Professional | 80 · Assistant surgeon | $245.47 | $323.59 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $281.84 Typical High $407.38 | Professional | AS · PA/NP assist | $213.80 | $281.84 | $407.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,318.26 | $1,479.11 | $2,041.74 |
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 $1,479.11 Median $1,698.24 Typical High $3,388.44 | Professional | None | $1,479.11 | $1,698.24 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $11,220.18 | Facility | None | $54.95 | $1,348.96 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $3,311.31 Typical High $17,782.79 | Professional | None | $1,819.70 | $3,311.31 | $17,782.79 |
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 $1,548.82 Median $2,238.72 Typical High $3,890.45 | Professional | None | $1,548.82 | $2,238.72 | $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 $676.08 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $676.08 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $338.84 Typical High $346.74 | Professional | 53 · Discontinued | $269.15 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,258.93 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,000.00 | $1,258.93 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $251.19 Typical High $257.04 | Professional | 55 · Aftercare only | $199.53 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $169.82 Typical High $173.78 | Professional | 56 · Pre-op care only | $134.90 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,174.90 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $933.25 | $1,174.90 | $1,202.26 |
Where Missouri sits
The same service costs 11.6 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 $24,998MD $2,147
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.