How much rates vary
Facilitymedian $3,090 · 10th to 90th $457 to $13,490Professionalmedian $3,162 · 10th to 90th $2,455 to $5,248
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 $2,630.27 Median $3,090.30 Typical High $3,467.37 | Facility | None | $2,630.27 | $3,090.30 | $3,467.37 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,630.27 | $2,884.03 | $3,467.37 |
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 $2,398.83 Median $2,884.03 Typical High $4,466.84 | Professional | None | $2,398.83 | $2,884.03 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,819.70 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,513.56 | $1,819.70 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $380.19 Median $467.74 Typical High $691.83 | Professional | 80 · Assistant surgeon | $380.19 | $467.74 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $407.38 Typical High $602.56 | Professional | AS · PA/NP assist | $338.84 | $407.38 | $602.56 |
CareSource Setting Facility Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $4,677.35 | Facility | None | $2,511.89 | $3,019.95 | $4,677.35 |
CareSource Setting Professional Modifier None Typical Low $3,235.94 Median $4,168.69 Typical High $4,897.79 | Professional | None | $3,235.94 | $4,168.69 | $4,897.79 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $5,248.07 | Facility | None | $34.67 | $512.86 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $4,466.84 Typical High $18,197.01 | Professional | None | $3,019.95 | $4,466.84 | $18,197.01 |
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 $3,090.30 Median $3,981.07 Typical High $5,754.40 | Professional | None | $3,090.30 | $3,981.07 | $5,754.40 |
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 $1,318.26 Median $1,445.44 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,318.26 | $1,445.44 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $575.44 Typical High $691.83 | Professional | 53 · Discontinued | $524.81 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,187.76 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,995.26 | $2,187.76 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $436.52 Typical High $524.81 | Professional | 55 · Aftercare only | $398.11 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $288.40 Typical High $346.74 | Professional | 56 · Pre-op care only | $263.03 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,041.74 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,041.74 | $2,398.83 |
Where Kentucky 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.