How much rates vary
Facilitymedian $2,570 · 10th to 90th $457 to $13,490Professionalmedian $2,570 · 10th to 90th $1,995 to $4,169
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 $1,995.26 Median $2,344.23 Typical High $2,691.53 | Facility | None | $1,995.26 | $2,344.23 | $2,691.53 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,995.26 | $2,187.76 | $2,691.53 |
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 $1,995.26 Median $2,570.40 Typical High $3,388.44 | Professional | None | $1,995.26 | $2,570.40 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,801.89 Typical High $5,128.61 | Professional | 50 · Both sides | $3,019.95 | $3,801.89 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,621.81 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,258.93 | $1,621.81 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $407.38 Typical High $537.03 | Professional | 80 · Assistant surgeon | $323.59 | $407.38 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $354.81 Typical High $478.63 | Professional | AS · PA/NP assist | $281.84 | $354.81 | $478.63 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $3,548.13 | Facility | None | $1,905.46 | $2,290.87 | $3,548.13 |
CareSource Setting Professional Modifier None Typical Low $2,238.72 Median $3,162.28 Typical High $3,715.35 | Professional | None | $2,238.72 | $3,162.28 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,715.35 | Facility | None | $34.67 | $691.83 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $3,467.37 Typical High $14,125.38 | Professional | None | $2,290.87 | $3,467.37 | $14,125.38 |
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 $2,398.83 Median $3,235.94 Typical High $4,466.84 | Professional | None | $2,398.83 | $3,235.94 | $4,466.84 |
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 $1,000.00 Median $1,096.48 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,000.00 | $1,096.48 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $436.52 Typical High $537.03 | Professional | 53 · Discontinued | $398.11 | $436.52 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,621.81 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,513.56 | $1,621.81 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $323.59 Typical High $407.38 | Professional | 55 · Aftercare only | $302.00 | $323.59 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $218.78 Typical High $269.15 | Professional | 56 · Pre-op care only | $199.53 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,513.56 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,513.56 | $1,905.46 |
Where Kentucky 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.