How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $2,754 · 10th to 90th $1,905 to $5,754
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 $1,584.89 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,584.89 | $1,905.46 | $2,511.89 |
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 $1,905.46 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,905.46 | $2,630.27 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,659.59 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,202.26 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $416.87 Typical High $562.34 | Professional | 80 · Assistant surgeon | $302.00 | $416.87 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $371.54 Typical High $489.78 | Professional | AS · PA/NP assist | $263.03 | $371.54 | $489.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,819.70 | $1,995.26 | $2,818.38 |
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 $1,949.84 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,949.84 | $2,137.96 | $4,168.69 |
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 $2,238.72 Median $4,265.80 Typical High $15,848.93 | Professional | None | $2,238.72 | $4,265.80 | $15,848.93 |
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 $2,041.74 Median $2,818.38 Typical High $5,128.61 | Professional | None | $2,041.74 | $2,818.38 | $5,128.61 |
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 $794.33 Median $933.25 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $380.19 Typical High $389.05 | Professional | 53 · Discontinued | $316.23 | $380.19 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,412.54 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,174.90 | $1,412.54 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $281.84 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $190.55 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,318.26 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,318.26 | $1,348.96 |
Where Missouri 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.