How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $1,514 · 10th to 90th $1,122 to $3,311
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 $1,348.96 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,348.96 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,122.02 Typical High $1,288.25 | Professional | None | $954.99 | $1,122.02 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,202.26 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,023.29 Typical High $1,412.54 | Professional | 62 · Two surgeons | $758.58 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $263.03 Typical High $354.81 | Professional | 80 · Assistant surgeon | $194.98 | $263.03 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $229.09 Typical High $309.03 | Professional | AS · PA/NP assist | $169.82 | $229.09 | $309.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,202.26 | $1,698.24 |
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 $1,071.52 Median $1,348.96 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,348.96 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,258.93 Typical High $11,220.18 | Facility | None | $54.95 | $1,258.93 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $2,137.96 Typical High $8,128.31 | Professional | None | $1,148.15 | $2,137.96 | $8,128.31 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,380.38 | $2,187.76 |
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 $478.63 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $223.87 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $144.54 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $794.33 | $794.33 |
Where Missouri 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.