How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $3,631 · 10th to 90th $2,399 to $6,607
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 $2,041.74 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,041.74 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,884.03 | Professional | None | $2,041.74 | $2,398.83 | $2,884.03 |
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 $2,454.71 Median $3,467.37 Typical High $4,466.84 | Professional | None | $2,454.71 | $3,467.37 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,630.78 Median $5,248.07 Typical High $6,760.83 | Professional | 50 · Both sides | $3,630.78 | $5,248.07 | $6,760.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,187.76 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,548.82 | $2,187.76 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $562.34 Typical High $724.44 | Professional | 80 · Assistant surgeon | $389.05 | $562.34 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $489.78 Typical High $630.96 | Professional | AS · PA/NP assist | $338.84 | $489.78 | $630.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $3,235.94 | Professional | None | $2,089.30 | $2,344.23 | $3,235.94 |
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 $2,511.89 Median $2,884.03 Typical High $5,370.32 | Professional | None | $2,511.89 | $2,884.03 | $5,370.32 |
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 $2,884.03 Median $5,495.41 Typical High $18,197.01 | Professional | None | $2,884.03 | $5,495.41 | $18,197.01 |
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 $2,754.23 Median $3,801.89 Typical High $6,606.93 | Professional | None | $2,754.23 | $3,801.89 | $6,606.93 |
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 $1,023.29 Median $1,202.26 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,023.29 | $1,202.26 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $478.63 Typical High $501.19 | Professional | 53 · Discontinued | $407.38 | $478.63 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,819.70 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,548.82 | $1,819.70 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $363.08 Typical High $380.19 | Professional | 55 · Aftercare only | $309.03 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $239.88 Typical High $251.19 | Professional | 56 · Pre-op care only | $204.17 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,698.24 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,698.24 | $1,778.28 |
Where Missouri 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.