How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $11,482Professionalmedian $2,692 · 10th to 90th $1,820 to $5,012
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 $1,905.46 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,905.46 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $5,128.61 | Professional | None | $1,905.46 | $2,089.30 | $5,128.61 |
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 $1,819.70 Median $2,691.53 Typical High $4,677.35 | Professional | None | $1,819.70 | $2,691.53 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,698.24 Typical High $3,019.95 | Professional | 62 · Two surgeons | $1,202.26 | $1,698.24 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $467.74 Typical High $776.25 | Professional | 80 · Assistant surgeon | $302.00 | $467.74 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $371.54 Typical High $660.69 | Professional | AS · PA/NP assist | $269.15 | $371.54 | $660.69 |
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 $2,187.76 Median $3,162.28 Typical High $5,754.40 | Professional | None | $2,187.76 | $3,162.28 | $5,754.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,398.83 Typical High $5,011.87 | Professional | None | $1,905.46 | $2,398.83 | $5,011.87 |
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 $1,905.46 Median $2,754.23 Typical High $5,888.44 | Professional | None | $1,905.46 | $2,754.23 | $5,888.44 |
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 $954.99 Median $954.99 Typical High $1,122.02 | Professional | 52 · Reduced service | $954.99 | $954.99 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | 53 · Discontinued | $380.19 | $380.19 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $331.13 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,548.82 |
Where Georgia sits
The same service costs 13.4 times more in Maine than in Maryland. 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 $34,930MD $2,604
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.