How much rates vary
Facilitymedian $1,148 · 10th to 90th $513 to $7,943Professionalmedian $1,905 · 10th to 90th $1,318 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 $1,412.54 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,412.54 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,412.54 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $2,290.87 Typical High $10,715.19 | Facility | None | $707.95 | $2,290.87 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,318.26 | $1,905.46 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,202.26 Typical High $1,995.26 | Professional | 62 · Two surgeons | $891.25 | $1,202.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $309.03 Typical High $537.03 | Professional | 80 · Assistant surgeon | $223.87 | $309.03 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $269.15 Typical High $446.68 | Professional | AS · PA/NP assist | $199.53 | $269.15 | $446.68 |
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 $1,584.89 Median $2,187.76 Typical High $3,890.45 | Professional | None | $1,584.89 | $2,187.76 | $3,890.45 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $4,168.69 | Professional | None | $1,258.93 | $1,584.89 | $4,168.69 |
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 $1,445.44 Median $2,089.30 Typical High $4,265.80 | Professional | None | $1,445.44 | $2,089.30 | $4,265.80 |
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 $707.95 Median $707.95 Typical High $851.14 | Professional | 52 · Reduced service | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $251.19 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,174.90 |
Where Georgia sits
The same service costs 12.0 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 $24,859MD $2,076
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.