How much rates vary
Facilitymedian $6,310 · 10th to 90th $813 to $17,783Professionalmedian $4,169 · 10th to 90th $1,288 to $9,772
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 $1,202.26 Median $1,202.26 Typical High $14,454.40 | Facility | None | $1,202.26 | $1,202.26 | $14,454.40 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $15,848.93 | Professional | None | $1,202.26 | $1,202.26 | $15,848.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $10,715.19 Typical High $18,620.87 | Facility | None | $6,309.57 | $10,715.19 | $18,620.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $4,677.35 Typical High $10,715.19 | Professional | None | $1,621.81 | $4,677.35 | $10,715.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $2,951.21 Typical High $6,760.83 | Professional | 62 · Two surgeons | $1,023.29 | $2,951.21 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $758.58 Typical High $1,698.24 | Professional | 80 · Assistant surgeon | $257.04 | $758.58 | $1,698.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $660.69 Typical High $1,479.11 | Professional | AS · PA/NP assist | $223.87 | $660.69 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,311.31 Typical High $5,128.61 | Facility | None | $812.83 | $3,311.31 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $3,019.95 Typical High $4,570.88 | Professional | None | $2,041.74 | $3,019.95 | $4,570.88 |
DeanCare Setting Facility Modifier None Typical Low $1,412.54 Median $7,943.28 Typical High $14,454.40 | Facility | None | $1,412.54 | $7,943.28 | $14,454.40 |
DeanCare Setting Professional Modifier None Typical Low $2,290.87 Median $3,388.44 Typical High $4,570.88 | Professional | None | $2,290.87 | $3,388.44 | $4,570.88 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $2,454.71 Typical High $18,197.01 | Facility | None | $436.52 | $2,454.71 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $1,548.82 Median $3,890.45 Typical High $7,762.47 | Professional | None | $1,548.82 | $3,890.45 | $7,762.47 |
Network Health Setting Facility Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $2,691.53 | Facility | None | $1,905.46 | $2,089.30 | $2,691.53 |
Network Health Setting Professional Modifier None Typical Low $1,862.09 Median $3,235.94 Typical High $4,365.16 | Professional | None | $1,862.09 | $3,235.94 | $4,365.16 |
Prevea360 Setting Facility Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,818.38 | Facility | None | $1,174.90 | $1,412.54 | $2,818.38 |
Quartz Setting Professional Modifier None Typical Low $1,348.96 Median $3,090.30 Typical High $5,495.41 | Professional | None | $1,348.96 | $3,090.30 | $5,495.41 |
Quartz Setting Facility Modifier None Typical Low $758.58 Median $1,071.52 Typical High $3,630.78 | Facility | None | $758.58 | $1,071.52 | $3,630.78 |
Quartz Setting Professional Modifier None Typical Low $2,187.76 Median $2,398.83 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,398.83 | $3,801.89 |
Security Health Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Professional | None | $5,623.41 | $5,623.41 | $5,623.41 |
Security Health Setting Professional Modifier None Typical Low $5,370.32 Median $8,128.31 Typical High $9,120.11 | Professional | None | $5,370.32 | $8,128.31 | $9,120.11 |
United Setting Facility Modifier None Typical Low $602.56 Median $3,090.30 Typical High $18,197.01 | Facility | None | $602.56 | $3,090.30 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $3,388.44 Typical High $6,606.93 | Professional | None | $1,288.25 | $3,388.44 | $6,606.93 |
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 $602.56 Median $602.56 Typical High $7,943.28 | Professional | 52 · Reduced service | $602.56 | $602.56 | $7,943.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $3,235.94 | Professional | 53 · Discontinued | $239.88 | $239.88 | $3,235.94 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $912.01 Typical High $12,022.64 | Professional | 54 · Surgery only | $912.01 | $912.01 | $12,022.64 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $2,398.83 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $2,398.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $1,584.89 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $1,584.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $851.14 Typical High $11,220.18 | Professional | 78 · Unplanned return to OR | $851.14 | $851.14 | $11,220.18 |
Where Wisconsin sits
The same service costs 14.4 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 $28,865MD $2,008
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.