How much rates vary
Facilitymedian $1,820 · 10th to 90th $550 to $8,318Professionalmedian $1,622 · 10th to 90th $1,000 to $3,090
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 $933.25 Median $5,370.32 Typical High $7,943.28 | Facility | None | $933.25 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $3,162.28 | Professional | None | $933.25 | $1,258.93 | $3,162.28 |
Ambetter Setting Professional Modifier None Typical Low $1,000.00 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,949.84 | $2,137.96 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $295.12 Typical High $309.03 | Professional | 80 · Assistant surgeon | $162.18 | $295.12 | $309.03 |
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 $1,000.00 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,000.00 | $1,621.81 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,071.52 Typical High $1,949.84 | Professional | 62 · Two surgeons | $776.25 | $1,071.52 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $309.03 Typical High $501.19 | Professional | 80 · Assistant surgeon | $213.80 | $309.03 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $239.88 Typical High $436.52 | Professional | AS · PA/NP assist | $173.78 | $239.88 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,905.46 Typical High $3,162.28 | Professional | None | $1,174.90 | $1,905.46 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $3,801.89 | Professional | None | $1,047.13 | $1,318.26 | $3,801.89 |
United Setting Facility Modifier None Typical Low $954.99 Median $1,995.26 Typical High $7,585.78 | Facility | None | $954.99 | $1,995.26 | $7,585.78 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,737.80 | $2,754.23 |
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 $467.74 Median $467.74 Typical High $645.65 | Professional | 52 · Reduced service | $467.74 | $467.74 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $257.04 | Professional | 53 · Discontinued | $190.55 | $190.55 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | 54 · Surgery only | $707.95 | $707.95 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $190.55 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $891.25 |
Where Georgia sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.