How much rates vary
Facilitymedian $1,862 · 10th to 90th $457 to $11,220Professionalmedian $1,202 · 10th to 90th $933 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 $1,047.13 Median $1,071.52 Typical High $1,445.44 | Facility | None | $1,047.13 | $1,071.52 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,445.44 | Professional | None | $1,047.13 | $1,047.13 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,025.60 Median $10,000.00 Typical High $16,218.10 | Facility | None | $6,025.60 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,202.26 Typical High $1,905.46 | Professional | None | $933.25 | $1,202.26 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $758.58 Typical High $1,202.26 | Professional | 62 · Two surgeons | $588.84 | $758.58 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $190.55 Typical High $302.00 | Professional | 80 · Assistant surgeon | $147.91 | $190.55 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $165.96 Typical High $263.03 | Professional | AS · PA/NP assist | $128.82 | $165.96 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $870.96 Median $1,047.13 Typical High $1,659.59 | Facility | None | $870.96 | $1,047.13 | $1,659.59 |
CareSource Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $1,698.24 | Professional | None | $1,047.13 | $1,445.44 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,905.46 | Facility | None | $34.67 | $691.83 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,621.81 Typical High $7,413.10 | Professional | None | $1,071.52 | $1,621.81 | $7,413.10 |
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 $1,000.00 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,000.00 | $1,258.93 | $1,995.26 |
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 $512.86 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $512.86 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $776.25 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $776.25 |
Where Kentucky sits
The same service costs 15.4 times more in Maine than in Maryland. 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 $28,500MD $1,851
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.