How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $9,120Professionalmedian $1,413 · 10th to 90th $912 to $2,630
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 $831.76 Median $7,079.46 Typical High $12,302.69 | Facility | None | $831.76 | $7,079.46 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $2,754.23 | Professional | None | $831.76 | $1,122.02 | $2,754.23 |
Ambetter Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $1,862.09 | Professional | None | $933.25 | $1,318.26 | $1,862.09 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $257.04 Typical High $295.12 | Professional | 80 · Assistant surgeon | $162.18 | $257.04 | $295.12 |
Ambetter Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $295.12 Typical High $295.12 | Professional | AS · PA/NP assist | $223.87 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $831.76 Median $2,570.40 Typical High $11,220.18 | Facility | None | $831.76 | $2,570.40 | $11,220.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,412.54 Typical High $2,630.27 | Professional | None | $933.25 | $1,412.54 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $954.99 Typical High $1,698.24 | Professional | 62 · Two surgeons | $676.08 | $954.99 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $263.03 Typical High $436.52 | Professional | 80 · Assistant surgeon | $165.96 | $263.03 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $213.80 Typical High $380.19 | Professional | AS · PA/NP assist | $151.36 | $213.80 | $380.19 |
CareSource Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,258.93 | $1,258.93 | $1,380.38 |
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 $1,047.13 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,047.13 | $1,698.24 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $3,311.31 | Professional | None | $954.99 | $1,202.26 | $3,311.31 |
Oscar Health Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $1,023.29 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,023.29 | $1,445.44 | $2,398.83 |
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 $407.38 Median $407.38 Typical High $562.34 | Professional | 52 · Reduced service | $407.38 | $407.38 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $223.87 | Professional | 53 · Discontinued | $165.96 | $165.96 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | 54 · Surgery only | $616.60 | $616.60 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $776.25 |
Where Georgia sits
The same service costs 10.4 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 $23,768TX $2,290
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.