How much rates vary
Facilitymedian $3,802 · 10th to 90th $501 to $19,498Professionalmedian $1,148 · 10th to 90th $138 to $1,778
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 $10,232.93 Typical High $13,803.84 | Facility | None | $1,047.13 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $4,786.30 | Professional | None | $1,047.13 | $1,047.13 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $9,332.54 Typical High $21,877.62 | Facility | None | $1,047.13 | $9,332.54 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,905.46 | Professional | None | $977.24 | $1,202.26 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $758.58 Typical High $1,202.26 | Professional | 62 · Two surgeons | $602.56 | $758.58 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $316.23 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,230.27 | $2,290.87 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,047.13 Median $1,174.90 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,174.90 | $2,398.83 |
Molina Setting Professional Modifier None Typical Low $123.03 Median $1,122.02 Typical High $1,621.81 | Professional | None | $123.03 | $1,122.02 | $1,621.81 |
SummaCare Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,096.48 | $1,659.59 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,570.40 | Professional | None | $1,023.29 | $1,258.93 | $2,570.40 |
7 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 $524.81 Median $524.81 Typical High $2,089.30 | Professional | 52 · Reduced service | $524.81 | $524.81 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $851.14 | Professional | 53 · Discontinued | $208.93 | $208.93 | $851.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $3,162.28 | Professional | 54 · Surgery only | $776.25 | $776.25 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $630.96 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $416.87 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $2,951.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $165.96 Typical High $269.15 | Professional | AS · PA/NP assist | $134.90 | $165.96 | $269.15 |
Where Ohio 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.