How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $1,778 · 10th to 90th $1,230 to $3,236
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 $1,258.93 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,258.93 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,258.93 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,819.70 Typical High $7,762.47 | Facility | None | $588.84 | $1,819.70 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,778.28 Typical High $3,090.30 | Professional | None | $1,202.26 | $1,778.28 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,122.02 Typical High $1,995.26 | Professional | 62 · Two surgeons | $794.33 | $1,122.02 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $309.03 Typical High $524.81 | Professional | 80 · Assistant surgeon | $204.17 | $309.03 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $251.19 Typical High $446.68 | Professional | AS · PA/NP assist | $177.83 | $251.19 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $2,511.89 | Facility | None | $446.68 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,479.11 | $2,089.30 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $3,715.35 | Professional | None | $1,288.25 | $1,584.89 | $3,715.35 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $3,890.45 | Professional | None | $1,258.93 | $1,819.70 | $3,890.45 |
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 $630.96 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $954.99 Typical High $1,122.02 | Professional | 54 · Surgery only | $954.99 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $891.25 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $891.25 | $891.25 | $1,047.13 |
Where Georgia sits
The same service costs 8.5 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 $16,489MD $1,943
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.