How much rates vary
Facilitymedian $3,162 · 10th to 90th $741 to $7,586Professionalmedian $912 · 10th to 90th $759 to $2,291
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 $1,778.28 Median $5,623.41 Typical High $8,709.64 | Facility | None | $1,778.28 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,621.81 | Professional | None | $616.60 | $776.25 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,412.54 | $3,801.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,445.44 | Professional | None | $758.58 | $891.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $912.01 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $144.54 Typical High $234.42 | Professional | 80 · Assistant surgeon | $120.23 | $144.54 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $125.89 Typical High $204.17 | Professional | AS · PA/NP assist | $107.15 | $125.89 | $204.17 |
BCBS Kansas City Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $1,148.15 | Professional | None | $741.31 | $812.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,819.70 | Professional | None | $758.58 | $891.25 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,137.96 Typical High $6,606.93 | Facility | None | $54.95 | $2,137.96 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,995.26 Typical High $5,888.44 | Professional | None | $831.76 | $1,995.26 | $5,888.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $6,760.83 | Facility | None | $1,000.00 | $3,388.44 | $6,760.83 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $2,089.30 | Professional | None | $794.33 | $1,096.48 | $2,089.30 |
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 $309.03 Median $380.19 Typical High $398.11 | Professional | 52 · Reduced service | $309.03 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $151.36 Typical High $158.49 | Professional | 53 · Discontinued | $123.03 | $151.36 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $575.44 Typical High $588.84 | Professional | 54 · Surgery only | $457.09 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $114.82 Typical High $117.49 | Professional | 55 · Aftercare only | $93.33 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $75.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $61.66 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $537.03 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $426.58 | $537.03 | $549.54 |
Where Missouri 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.