How much rates vary
Facilitymedian $3,388 · 10th to 90th $977 to $10,715Professionalmedian $1,380 · 10th to 90th $1,072 to $2,188
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 $1,071.52 Median $1,258.93 Typical High $8,511.38 | Facility | None | $1,071.52 | $1,258.93 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,071.52 | $1,174.90 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $4,897.79 Typical High $12,022.64 | Facility | None | $1,737.80 | $4,897.79 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,071.52 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $831.76 Typical High $1,148.15 | Professional | 62 · Two surgeons | $676.08 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $295.12 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $181.97 Typical High $257.04 | Professional | AS · PA/NP assist | $151.36 | $181.97 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,023.29 Median $1,230.27 Typical High $1,905.46 | Facility | None | $1,023.29 | $1,230.27 | $1,905.46 |
CareSource Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $1,995.26 | Professional | None | $1,202.26 | $1,698.24 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $2,089.30 | Facility | None | $34.67 | $512.86 | $2,089.30 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $7,413.10 | Professional | None | $1,230.27 | $1,819.70 | $7,413.10 |
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 $977.24 Median $1,862.09 Typical High $7,943.28 | Facility | None | $977.24 | $1,862.09 | $7,943.28 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,698.24 | $2,398.83 |
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 $537.03 Median $588.84 Typical High $707.95 | Professional | 52 · Reduced service | $537.03 | $588.84 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $234.42 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $870.96 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $177.83 Typical High $208.93 | Professional | 55 · Aftercare only | $162.18 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $117.49 Typical High $141.25 | Professional | 56 · Pre-op care only | $107.15 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $977.24 |
Where Kentucky sits
The same service costs 13.5 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 $34,179TX $2,531
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.