How much rates vary
Facilitymedian $3,467 · 10th to 90th $490 to $11,749Professionalmedian $1,175 · 10th to 90th $174 to $1,862
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 $1,122.02 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,122.02 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $5,888.44 | Professional | None | $1,122.02 | $1,122.02 | $5,888.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $6,165.95 Typical High $12,882.50 | Facility | None | $933.25 | $6,165.95 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,949.84 | Professional | None | $954.99 | $1,202.26 | $1,949.84 |
CareSource Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Facility | None | $1,548.82 | $1,548.82 | $1,548.82 |
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 $1,202.26 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,621.81 | $2,630.27 |
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 $1,202.26 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,202.26 | $1,621.81 | $2,630.27 |
Molina Setting Professional Modifier None Typical Low $158.49 Median $1,071.52 Typical High $1,698.24 | Professional | None | $158.49 | $1,071.52 | $1,698.24 |
SummaCare Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,258.93 | $1,862.09 |
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 $1,174.90 Median $1,621.81 Typical High $3,090.30 | Professional | None | $1,174.90 | $1,621.81 | $3,090.30 |
9 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 $562.34 Median $562.34 Typical High $2,089.30 | Professional | 52 · Reduced service | $562.34 | $562.34 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $831.76 | Professional | 53 · Discontinued | $223.87 | $223.87 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $3,162.28 | Professional | 54 · Surgery only | $851.14 | $851.14 | $3,162.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $630.96 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $630.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $416.87 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $2,951.21 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $758.58 Typical High $1,230.27 | Professional | 62 · Two surgeons | $602.56 | $758.58 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $190.55 Typical High $316.23 | Professional | 80 · Assistant surgeon | $151.36 | $190.55 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $165.96 Typical High $275.42 | Professional | AS · PA/NP assist | $134.90 | $165.96 | $275.42 |
Where Ohio 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.