How much rates vary
Facilitymedian $2,188 · 10th to 90th $457 to $13,490Professionalmedian $2,089 · 10th to 90th $1,698 to $3,467
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 $2,089.30 Typical High $2,187.76 | Facility | None | $1,778.28 | $2,089.30 | $2,187.76 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,778.28 | $1,949.84 | $2,344.23 |
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 $1,698.24 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,698.24 | $2,089.30 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,318.26 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,071.52 | $1,318.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $331.13 Typical High $467.74 | Professional | 80 · Assistant surgeon | $275.42 | $331.13 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $288.40 Typical High $407.38 | Professional | AS · PA/NP assist | $239.88 | $288.40 | $407.38 |
CareSource Setting Facility Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $3,162.28 | Facility | None | $1,698.24 | $1,995.26 | $3,162.28 |
CareSource Setting Professional Modifier None Typical Low $1,819.70 Median $2,754.23 Typical High $3,235.94 | Professional | None | $1,819.70 | $2,754.23 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,630.78 | Facility | None | $34.67 | $512.86 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $11,481.54 | Professional | None | $2,041.74 | $2,884.03 | $11,481.54 |
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 $2,041.74 Median $2,630.27 Typical High $3,801.89 | Professional | None | $2,041.74 | $2,630.27 | $3,801.89 |
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 $891.25 Median $977.24 Typical High $1,096.48 | Professional | 52 · Reduced service | $891.25 | $977.24 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $389.05 Typical High $436.52 | Professional | 53 · Discontinued | $354.81 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,445.44 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,348.96 | $1,445.44 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $288.40 Typical High $323.59 | Professional | 55 · Aftercare only | $269.15 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $194.98 Typical High $218.78 | Professional | 56 · Pre-op care only | $177.83 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,348.96 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,348.96 | $1,513.56 |
Where Kentucky sits
The same service costs 13.8 times more in Maine than in Texas. 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 $35,243TX $2,555
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.