How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $11,482Professionalmedian $4,074 · 10th to 90th $2,754 to $7,586
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 $3,019.95 Median $5,370.32 Typical High $7,943.28 | Facility | None | $3,019.95 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,981.07 | Professional | None | $3,019.95 | $3,019.95 | $3,981.07 |
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 $2,691.53 Median $4,073.80 Typical High $7,244.36 | Professional | None | $2,691.53 | $4,073.80 | $7,244.36 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,862.09 Median $2,754.23 Typical High $4,786.30 | Professional | 62 · Two surgeons | $1,862.09 | $2,754.23 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $467.74 Median $741.31 Typical High $1,202.26 | Professional | 80 · Assistant surgeon | $467.74 | $741.31 | $1,202.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $407.38 Median $602.56 Typical High $1,047.13 | Professional | AS · PA/NP assist | $407.38 | $602.56 | $1,047.13 |
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 $3,467.37 Median $4,897.79 Typical High $8,912.51 | Professional | None | $3,467.37 | $4,897.79 | $8,912.51 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,548.13 Typical High $6,606.93 | Professional | None | $2,818.38 | $3,548.13 | $6,606.93 |
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 $3,019.95 Median $4,365.16 Typical High $9,120.11 | Professional | None | $3,019.95 | $4,365.16 | $9,120.11 |
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 $1,513.56 Median $1,513.56 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,513.56 | $1,513.56 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $602.56 Median $602.56 Typical High $707.95 | Professional | 53 · Discontinued | $602.56 | $602.56 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,238.72 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,238.72 | $2,238.72 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $457.09 Median $457.09 Typical High $524.81 | Professional | 55 · Aftercare only | $457.09 | $457.09 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $302.00 Median $302.00 Typical High $346.74 | Professional | 56 · Pre-op care only | $302.00 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,089.30 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,089.30 | $2,454.71 |
Where Georgia sits
The same service costs 9.8 times more in Maine than in Maryland. 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 $36,528MD $3,725
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.