How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $13,490Professionalmedian $1,950 · 10th to 90th $1,585 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 $1,659.59 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,659.59 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,659.59 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $10,715.19 Typical High $19,498.45 | Facility | None | $7,244.36 | $10,715.19 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,905.46 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,202.26 Typical High $1,659.59 | Professional | 62 · Two surgeons | $1,000.00 | $1,202.26 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $309.03 Typical High $426.58 | Professional | 80 · Assistant surgeon | $251.19 | $309.03 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $269.15 Typical High $371.54 | Professional | AS · PA/NP assist | $218.78 | $269.15 | $371.54 |
CareSource Setting Facility Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,951.21 | Facility | None | $1,584.89 | $1,905.46 | $2,951.21 |
CareSource Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $3,090.30 | Professional | None | $1,862.09 | $2,570.40 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,388.44 | Facility | None | $34.67 | $512.86 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $10,232.93 | Professional | None | $1,905.46 | $2,754.23 | $10,232.93 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,454.71 | $3,548.13 |
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 $831.76 Median $912.01 Typical High $977.24 | Professional | 52 · Reduced service | $831.76 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $363.08 Typical High $389.05 | Professional | 53 · Discontinued | $331.13 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,348.96 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,258.93 | $1,348.96 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $295.12 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $181.97 Typical High $194.98 | Professional | 56 · Pre-op care only | $165.96 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,258.93 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,258.93 | $1,348.96 |
Where Kentucky 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.