How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $2,951 · 10th to 90th $1,995 to $6,166
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 $1,778.28 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,659.59 | $1,995.26 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,818.38 Typical High $3,630.78 | Professional | None | $2,041.74 | $2,818.38 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,778.28 Typical High $2,290.87 | Professional | 62 · Two surgeons | $1,288.25 | $1,778.28 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $446.68 Typical High $588.84 | Professional | 80 · Assistant surgeon | $323.59 | $446.68 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $389.05 Typical High $512.86 | Professional | AS · PA/NP assist | $281.84 | $389.05 | $512.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,949.84 | $2,187.76 | $3,019.95 |
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 $2,089.30 Median $2,290.87 Typical High $4,466.84 | Professional | None | $2,089.30 | $2,290.87 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $2,344.23 Median $4,466.84 Typical High $14,125.38 | Professional | None | $2,344.23 | $4,466.84 | $14,125.38 |
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 $2,187.76 Median $3,019.95 Typical High $5,370.32 | Professional | None | $2,187.76 | $3,019.95 | $5,370.32 |
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 $1,000.00 Typical High $1,023.29 | Professional | 52 · Reduced service | $831.76 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $398.11 Typical High $407.38 | Professional | 53 · Discontinued | $331.13 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $1,513.56 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,258.93 | $1,513.56 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $302.00 Typical High $309.03 | Professional | 55 · Aftercare only | $251.19 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $199.53 Typical High $204.17 | Professional | 56 · Pre-op care only | $165.96 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,412.54 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,412.54 | $1,445.44 |
Where Missouri 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.