How much rates vary
Facilitymedian $3,020 · 10th to 90th $794 to $14,125Professionalmedian $4,074 · 10th to 90th $1,318 to $9,772
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 $1,318.26 Median $1,318.26 Typical High $14,454.40 | Facility | None | $1,318.26 | $1,318.26 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $12,302.69 | Professional | None | $1,318.26 | $1,318.26 | $12,302.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $9,772.37 Typical High $16,982.44 | Facility | None | $1,202.26 | $9,772.37 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $4,786.30 Typical High $10,000.00 | Professional | None | $1,548.82 | $4,786.30 | $10,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $3,019.95 Typical High $6,309.57 | Professional | 62 · Two surgeons | $977.24 | $3,019.95 | $6,309.57 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $758.58 Typical High $1,584.89 | Professional | 80 · Assistant surgeon | $251.19 | $758.58 | $1,584.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $676.08 Typical High $1,412.54 | Professional | AS · PA/NP assist | $218.78 | $676.08 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,311.31 Typical High $5,011.87 | Facility | None | $812.83 | $3,311.31 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,630.27 Typical High $4,570.88 | Professional | None | $1,737.80 | $2,630.27 | $4,570.88 |
DeanCare Setting Facility Modifier None Typical Low $1,380.38 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,380.38 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $4,265.80 | Professional | None | $2,238.72 | $3,311.31 | $4,265.80 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $1,548.82 Typical High $3,630.78 | Facility | None | $407.38 | $1,548.82 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $4,073.80 Typical High $8,511.38 | Professional | None | $1,479.11 | $4,073.80 | $8,511.38 |
Network Health Setting Facility Modifier None Typical Low $1,122.02 Median $1,819.70 Typical High $3,235.94 | Facility | None | $1,122.02 | $1,819.70 | $3,235.94 |
Network Health Setting Professional Modifier None Typical Low $1,862.09 Median $3,162.28 Typical High $4,168.69 | Professional | None | $1,862.09 | $3,162.28 | $4,168.69 |
Prevea360 Setting Facility Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,570.40 | Facility | None | $1,148.15 | $1,479.11 | $2,570.40 |
Quartz Setting Professional Modifier None Typical Low $1,258.93 Median $2,884.03 Typical High $5,370.32 | Professional | None | $1,258.93 | $2,884.03 | $5,370.32 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $4,073.80 | Professional | None | $1,737.80 | $1,737.80 | $4,073.80 |
Security Health Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $6,456.54 | Professional | None | $6,456.54 | $6,456.54 | $6,456.54 |
Security Health Setting Professional Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,772.37 | Professional | None | $6,165.95 | $7,413.10 | $9,772.37 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,041.74 Typical High $3,548.13 | Facility | None | $467.74 | $2,041.74 | $3,548.13 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $3,548.13 Typical High $6,309.57 | Professional | None | $1,230.27 | $3,548.13 | $6,309.57 |
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 $660.69 Median $660.69 Typical High $6,025.60 | Professional | 52 · Reduced service | $660.69 | $660.69 | $6,025.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $2,454.71 | Professional | 53 · Discontinued | $263.03 | $263.03 | $2,454.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $9,120.11 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $9,120.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $1,819.70 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $1,819.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $1,230.27 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $1,230.27 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $8,511.38 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $8,511.38 |
Where Wisconsin 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.