How much rates vary
Facilitymedian $1,479 · 10th to 90th $457 to $8,710Professionalmedian $1,023 · 10th to 90th $759 to $1,549
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 $758.58 Median $851.14 Typical High $1,122.02 | Facility | None | $758.58 | $851.14 | $1,122.02 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,380.38 | Professional | None | $691.83 | $851.14 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Ambetter Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 80 · Assistant surgeon | $177.83 | $177.83 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,370.32 Typical High $10,715.19 | Facility | None | $3,235.94 | $5,370.32 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,318.26 | Professional | None | $758.58 | $1,023.29 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $645.65 Typical High $794.33 | Professional | 62 · Two surgeons | $478.63 | $645.65 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $162.18 Typical High $208.93 | Professional | 80 · Assistant surgeon | $123.03 | $162.18 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $141.25 Typical High $177.83 | Professional | AS · PA/NP assist | $107.15 | $141.25 | $177.83 |
CareSource Setting Facility Modifier None Typical Low $707.95 Median $954.99 Typical High $1,348.96 | Facility | None | $707.95 | $954.99 | $1,348.96 |
CareSource Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,258.93 | Professional | None | $851.14 | $933.25 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $1,479.11 | Facility | None | $34.67 | $512.86 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $5,754.40 | Professional | None | $891.25 | $1,288.25 | $5,754.40 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,479.11 | Professional | None | $831.76 | $933.25 | $1,479.11 |
3 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 $346.74 Median $380.19 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $154.88 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $154.88 | $181.97 |
Ambetter Setting Professional Modifier GC · Resident with teaching physician Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Professional | GC · Resident with teaching physician | $1,000.00 | $1,000.00 | $1,000.00 |
Where Kentucky sits
The same service costs 10.3 times more in Maine than in Arkansas. 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 $15,629AR $1,524
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.