How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $11,482Professionalmedian $2,818 · 10th to 90th $1,950 to $5,370
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 $2,041.74 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,041.74 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $5,370.32 | Professional | None | $2,041.74 | $2,187.76 | $5,370.32 |
Ambetter Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $3,162.28 Typical High $16,218.10 | Facility | None | $1,122.02 | $3,162.28 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,818.38 Typical High $4,897.79 | Professional | None | $1,862.09 | $2,818.38 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,862.09 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,288.25 | $1,862.09 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $489.78 Typical High $831.76 | Professional | 80 · Assistant surgeon | $323.59 | $489.78 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $398.11 Typical High $691.83 | Professional | AS · PA/NP assist | $281.84 | $398.11 | $691.83 |
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 $2,344.23 Median $3,388.44 Typical High $6,165.95 | Professional | None | $2,344.23 | $3,388.44 | $6,165.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $5,888.44 | Professional | None | $2,041.74 | $2,511.89 | $5,888.44 |
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 $1,995.26 Median $2,818.38 Typical High $6,309.57 | Professional | None | $1,995.26 | $2,818.38 | $6,309.57 |
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 $1,023.29 Median $1,023.29 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | 53 · Discontinued | $407.38 | $407.38 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $354.81 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $234.42 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,659.59 |
Where Georgia sits
The same service costs 13.8 times more in Maine than in Washington. 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 $35,114WA $2,549
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.