How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $11,482Professionalmedian $4,571 · 10th to 90th $3,020 to $8,318
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 $3,235.94 Median $5,370.32 Typical High $7,943.28 | Facility | None | $3,235.94 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,311.31 Typical High $5,370.32 | Professional | None | $3,235.94 | $3,311.31 | $5,370.32 |
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 $3,019.95 Median $4,570.88 Typical High $7,762.47 | Professional | None | $3,019.95 | $4,570.88 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,041.74 Median $2,951.21 Typical High $5,248.07 | Professional | 62 · Two surgeons | $2,041.74 | $2,951.21 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $512.86 Median $812.83 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $512.86 | $812.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $457.09 Median $630.96 Typical High $1,148.15 | Professional | AS · PA/NP assist | $457.09 | $630.96 | $1,148.15 |
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 $3,801.89 Median $5,248.07 Typical High $9,772.37 | Professional | None | $3,801.89 | $5,248.07 | $9,772.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $3,162.28 Median $3,981.07 Typical High $7,079.46 | Professional | None | $3,162.28 | $3,981.07 | $7,079.46 |
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 $3,235.94 Median $4,786.30 Typical High $10,000.00 | Professional | None | $3,235.94 | $4,786.30 | $10,000.00 |
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 $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,621.81 | $1,621.81 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $645.65 Typical High $758.58 | Professional | 53 · Discontinued | $645.65 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,398.83 Typical High $2,818.38 | Professional | 54 · Surgery only | $2,398.83 | $2,398.83 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $478.63 Typical High $562.34 | Professional | 55 · Aftercare only | $478.63 | $478.63 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $323.59 Typical High $380.19 | Professional | 56 · Pre-op care only | $323.59 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,238.72 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,238.72 | $2,630.27 |
Where Georgia sits
The same service costs 10.8 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 $36,725WA $3,399
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.