How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $2,188 · 10th to 90th $288 to $3,388
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 $2,187.76 Median $10,715.19 Typical High $13,803.84 | Facility | None | $2,187.76 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $10,964.78 | Professional | None | $2,187.76 | $2,187.76 | $10,964.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $12,022.64 Typical High $28,183.83 | Facility | None | $1,479.11 | $12,022.64 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,890.45 | Professional | None | $1,995.26 | $2,344.23 | $3,890.45 |
CareSource Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Facility | None | $2,951.21 | $2,951.21 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $3,162.28 Typical High $5,128.61 | Professional | None | $2,089.30 | $3,162.28 | $5,128.61 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $602.56 Typical High $2,691.53 | Facility | None | $426.58 | $602.56 | $2,691.53 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $2,089.30 Median $3,162.28 Typical High $5,248.07 | Professional | None | $2,089.30 | $3,162.28 | $5,248.07 |
Molina Setting Professional Modifier None Typical Low $275.42 Median $1,819.70 Typical High $2,884.03 | Professional | None | $275.42 | $1,819.70 | $2,884.03 |
SummaCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $3,467.37 | Professional | None | $2,137.96 | $2,137.96 | $3,467.37 |
United Setting Facility Modifier None Typical Low $371.54 Median $977.24 Typical High $4,677.35 | Facility | None | $371.54 | $977.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $2,290.87 Median $3,311.31 Typical High $5,888.44 | Professional | None | $2,290.87 | $3,311.31 | $5,888.44 |
10 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 $1,096.48 Median $1,096.48 Typical High $5,495.41 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $5,495.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $2,187.76 | Professional | 53 · Discontinued | $436.52 | $436.52 | $2,187.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $8,128.31 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $8,128.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $1,621.81 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $1,621.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $1,096.48 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $7,585.78 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $7,585.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,951.21 Median $3,467.37 Typical High $5,623.41 | Professional | 50 · Both sides | $2,951.21 | $3,467.37 | $5,623.41 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,479.11 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,258.93 | $1,479.11 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $371.54 Typical High $616.60 | Professional | 80 · Assistant surgeon | $316.23 | $371.54 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $323.59 Typical High $537.03 | Professional | AS · PA/NP assist | $275.42 | $323.59 | $537.03 |
Where Ohio 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.