How much rates vary
Facilitymedian $3,236 · 10th to 90th $457 to $16,596Professionalmedian $1,259 · 10th to 90th $138 to $1,862
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 $1,258.93 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,258.93 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $4,677.35 | Professional | None | $1,258.93 | $1,258.93 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,000.00 Median $7,943.28 Typical High $19,952.62 | Facility | None | $1,000.00 | $7,943.28 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,949.84 | Professional | None | $1,000.00 | $1,174.90 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $741.31 Typical High $1,230.27 | Professional | 62 · Two surgeons | $630.96 | $741.31 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $316.23 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,380.38 | $2,570.40 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,380.38 | $2,570.40 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,202.26 Typical High $1,698.24 | Professional | None | $123.03 | $1,202.26 | $1,698.24 |
SummaCare Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,174.90 | $1,819.70 |
United Setting Facility Modifier None Typical Low $338.84 Median $645.65 Typical High $3,311.31 | Facility | None | $338.84 | $645.65 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $3,019.95 | Professional | None | $1,202.26 | $1,479.11 | $3,019.95 |
7 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 $630.96 Typical High $2,089.30 | Professional | 52 · Reduced service | $630.96 | $630.96 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $831.76 | Professional | 53 · Discontinued | $251.19 | $251.19 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $3,162.28 | Professional | 54 · Surgery only | $954.99 | $954.99 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $630.96 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $416.87 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $2,951.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $165.96 Typical High $275.42 | Professional | AS · PA/NP assist | $141.25 | $165.96 | $275.42 |
Where Ohio 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.