How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,000Professionalmedian $1,862 · 10th to 90th $1,259 to $3,631
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 $1,513.56 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,513.56 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,258.93 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,000.00 | Facility | None | $1,412.54 | $3,801.89 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,737.80 Typical High $2,290.87 | Professional | None | $1,258.93 | $1,737.80 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,096.48 Typical High $1,445.44 | Professional | 62 · Two surgeons | $794.33 | $1,096.48 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $275.42 Typical High $363.08 | Professional | 80 · Assistant surgeon | $204.17 | $275.42 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $239.88 Typical High $316.23 | Professional | AS · PA/NP assist | $177.83 | $239.88 | $316.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,348.96 | $1,905.46 |
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 $1,318.26 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,445.44 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,288.25 Typical High $11,220.18 | Facility | None | $54.95 | $1,288.25 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $2,818.38 Typical High $8,912.51 | Professional | None | $1,479.11 | $2,818.38 | $8,912.51 |
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 $1,348.96 Median $1,905.46 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,905.46 | $3,388.44 |
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 $630.96 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $251.19 Typical High $257.04 | Professional | 53 · Discontinued | $208.93 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $954.99 | Professional | 54 · Surgery only | $776.25 | $933.25 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $125.89 Typical High $128.82 | Professional | 56 · Pre-op care only | $104.71 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $870.96 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $724.44 | $870.96 | $891.25 |
Where Missouri 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.