How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $11,482Professionalmedian $3,388 · 10th to 90th $2,138 to $6,166
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 $2,511.89 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,511.89 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,162.28 | Professional | None | $2,511.89 | $2,511.89 | $3,162.28 |
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 $2,041.74 Median $3,388.44 Typical High $6,025.60 | Professional | None | $2,041.74 | $3,388.44 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,715.35 Median $5,623.41 Typical High $9,332.54 | Professional | 50 · Both sides | $3,715.35 | $5,623.41 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,344.23 Typical High $3,890.45 | Professional | 62 · Two surgeons | $1,548.82 | $2,344.23 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $660.69 Typical High $1,023.29 | Professional | 80 · Assistant surgeon | $407.38 | $660.69 | $1,023.29 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $478.63 Typical High $912.01 | Professional | AS · PA/NP assist | $338.84 | $478.63 | $912.01 |
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 $2,818.38 Median $3,981.07 Typical High $7,413.10 | Professional | None | $2,818.38 | $3,981.07 | $7,413.10 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $5,495.41 | Professional | None | $2,137.96 | $2,691.53 | $5,495.41 |
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 $2,511.89 Median $3,630.78 Typical High $7,413.10 | Professional | None | $2,511.89 | $3,630.78 | $7,413.10 |
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 $1,258.93 Median $1,258.93 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,258.93 | $1,258.93 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $501.19 Typical High $575.44 | Professional | 53 · Discontinued | $501.19 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,862.09 | $1,862.09 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 55 · Aftercare only | $371.54 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $251.19 Typical High $288.40 | Professional | 56 · Pre-op care only | $251.19 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,737.80 | $1,737.80 | $2,041.74 |
Where Georgia sits
The same service costs 13.0 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 $35,671WA $2,745
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.