How much rates vary
Facilitymedian $1,862 · 10th to 90th $550 to $8,511Professionalmedian $1,122 · 10th to 90th $661 to $1,950
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 $870.96 Median $6,309.57 Typical High $10,000.00 | Facility | None | $870.96 | $6,309.57 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $2,187.76 | Professional | None | $645.65 | $851.14 | $2,187.76 |
Ambetter Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $724.44 Median $1,122.02 Typical High $1,862.09 | Professional | None | $724.44 | $1,122.02 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $724.44 Typical High $1,202.26 | Professional | 62 · Two surgeons | $512.86 | $724.44 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $190.55 Typical High $338.84 | Professional | 80 · Assistant surgeon | $128.82 | $190.55 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $158.49 Typical High $269.15 | Professional | AS · PA/NP assist | $112.20 | $158.49 | $269.15 |
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 $812.83 Median $1,230.27 Typical High $2,238.72 | Professional | None | $812.83 | $1,230.27 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,445.44 | Professional | None | $758.58 | $933.25 | $1,445.44 |
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 $794.33 Median $1,122.02 Typical High $1,862.09 | Professional | None | $794.33 | $1,122.02 | $1,862.09 |
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 $323.59 Median $323.59 Typical High $436.52 | Professional | 52 · Reduced service | $323.59 | $323.59 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | 53 · Discontinued | $128.82 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | 54 · Surgery only | $489.78 | $489.78 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $64.57 Typical High $89.13 | Professional | 56 · Pre-op care only | $64.57 | $64.57 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $457.09 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $457.09 | $457.09 | $616.60 |
Where Georgia sits
The same service costs 11.6 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 $23,484TX $2,029
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.