How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,471Professionalmedian $2,042 · 10th to 90th $1,380 to $3,890
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 $1,584.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,584.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,584.89 | $1,819.70 |
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 $1,479.11 Median $2,041.74 Typical High $2,754.23 | Professional | None | $1,479.11 | $2,041.74 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,288.25 Typical High $1,737.80 | Professional | 62 · Two surgeons | $933.25 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $323.59 Typical High $436.52 | Professional | 80 · Assistant surgeon | $234.42 | $323.59 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $288.40 Typical High $389.05 | Professional | AS · PA/NP assist | $204.17 | $288.40 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,380.38 | $1,949.84 |
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 $1,380.38 Median $1,584.89 Typical High $3,162.28 | Professional | None | $1,380.38 | $1,584.89 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $10,232.93 | Facility | None | $54.95 | $1,348.96 | $10,232.93 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $3,162.28 Typical High $12,302.69 | Professional | None | $1,698.24 | $3,162.28 | $12,302.69 |
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 $1,445.44 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,445.44 | $2,089.30 | $3,630.78 |
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 $630.96 Median $794.33 Typical High $812.83 | Professional | 52 · Reduced service | $630.96 | $794.33 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $316.23 Typical High $323.59 | Professional | 53 · Discontinued | $251.19 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,174.90 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $239.88 Typical High $245.47 | Professional | 55 · Aftercare only | $190.55 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $158.49 Typical High $162.18 | Professional | 56 · Pre-op care only | $125.89 | $158.49 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,096.48 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $1,096.48 | $1,122.02 |
Where Missouri 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.