How much rates vary
Facilitymedian $2,818 · 10th to 90th $525 to $10,965Professionalmedian $5,754 · 10th to 90th $4,467 to $12,303
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 $5,248.07 Typical High $7,762.47 | Facility | None | $2,511.89 | $5,248.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,715.35 Median $4,466.84 Typical High $4,897.79 | Professional | None | $3,715.35 | $4,466.84 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $12,882.50 | Facility | None | $1,412.54 | $3,801.89 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,786.30 Median $5,754.40 Typical High $8,317.64 | Professional | None | $4,786.30 | $5,754.40 | $8,317.64 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $3,019.95 Median $3,630.78 Typical High $5,248.07 | Professional | 62 · Two surgeons | $3,019.95 | $3,630.78 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $758.58 Median $912.01 Typical High $1,318.26 | Professional | 80 · Assistant surgeon | $758.58 | $912.01 | $1,318.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $676.08 Median $812.83 Typical High $1,148.15 | Professional | AS · PA/NP assist | $676.08 | $812.83 | $1,148.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $4,168.69 Median $4,786.30 Typical High $6,606.93 | Professional | None | $4,168.69 | $4,786.30 | $6,606.93 |
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 $4,786.30 Median $5,495.41 Typical High $10,232.93 | Professional | None | $4,786.30 | $5,495.41 | $10,232.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $12,022.64 | Facility | None | $54.95 | $1,380.38 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $5,495.41 Median $10,471.29 Typical High $31,622.78 | Professional | None | $5,495.41 | $10,471.29 | $31,622.78 |
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 $5,128.61 Median $7,079.46 Typical High $12,022.64 | Professional | None | $5,128.61 | $7,079.46 | $12,022.64 |
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 $1,862.09 Median $2,238.72 Typical High $2,290.87 | Professional | 52 · Reduced service | $1,862.09 | $2,238.72 | $2,290.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $912.01 Typical High $933.25 | Professional | 53 · Discontinued | $758.58 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,388.44 Typical High $3,467.37 | Professional | 54 · Surgery only | $2,818.38 | $3,388.44 | $3,467.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $676.08 Typical High $691.83 | Professional | 55 · Aftercare only | $562.34 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $371.54 Median $446.68 Typical High $467.74 | Professional | 56 · Pre-op care only | $371.54 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $3,162.28 Typical High $3,235.94 | Professional | 78 · Unplanned return to OR | $2,630.27 | $3,162.28 | $3,235.94 |
Where Missouri sits
The same service costs 8.7 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 $38,525WA $4,436
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.