How much rates vary
Facilitymedian $1,380 · 10th to 90th $398 to $5,623Professionalmedian $1,820 · 10th to 90th $1,288 to $4,169
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 $5,623.41 Typical High $9,549.93 | Facility | None | $1,698.24 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,479.11 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,778.28 Typical High $7,585.78 | Facility | None | $446.68 | $1,778.28 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,348.96 | $1,737.80 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,096.48 Typical High $1,584.89 | Professional | 62 · Two surgeons | $851.14 | $1,096.48 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $281.84 Typical High $407.38 | Professional | 80 · Assistant surgeon | $218.78 | $281.84 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $251.19 Typical High $354.81 | Professional | AS · PA/NP assist | $190.55 | $251.19 | $354.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,148.15 | $1,288.25 | $1,778.28 |
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 $1,288.25 Median $1,445.44 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,445.44 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,096.48 Typical High $3,548.13 | Facility | None | $54.95 | $1,096.48 | $3,548.13 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $2,884.03 Typical High $10,471.29 | Professional | None | $1,548.82 | $2,884.03 | $10,471.29 |
United Setting Facility Modifier None Typical Low $389.05 Median $1,148.15 Typical High $2,238.72 | Facility | None | $389.05 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,949.84 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,949.84 | $3,388.44 |
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 $588.84 Median $724.44 Typical High $741.31 | Professional | 52 · Reduced service | $588.84 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $295.12 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,096.48 Typical High $1,122.02 | Professional | 54 · Surgery only | $870.96 | $1,096.48 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $218.78 Typical High $223.87 | Professional | 55 · Aftercare only | $173.78 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $117.49 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,023.29 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $812.83 | $1,023.29 | $1,047.13 |
Where Missouri sits
The same service costs 13.1 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 $24,687MD $1,882
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.