How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $3,890 · 10th to 90th $2,630 to $7,413
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 $2,137.96 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,137.96 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,137.96 Median $2,630.27 Typical High $3,311.31 | Professional | None | $2,137.96 | $2,630.27 | $3,311.31 |
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 $2,630.27 Median $3,630.78 Typical High $4,786.30 | Professional | None | $2,630.27 | $3,630.78 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,659.59 Median $2,290.87 Typical High $3,019.95 | Professional | 62 · Two surgeons | $1,659.59 | $2,290.87 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $588.84 Typical High $776.25 | Professional | 80 · Assistant surgeon | $426.58 | $588.84 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $512.86 Typical High $676.08 | Professional | AS · PA/NP assist | $371.54 | $512.86 | $676.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,454.71 Median $2,754.23 Typical High $3,890.45 | Professional | None | $2,454.71 | $2,754.23 | $3,890.45 |
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 $2,691.53 Median $3,019.95 Typical High $5,754.40 | Professional | None | $2,691.53 | $3,019.95 | $5,754.40 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,481.54 | Facility | None | $54.95 | $1,380.38 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $3,090.30 Median $5,888.44 Typical High $18,197.01 | Professional | None | $3,090.30 | $5,888.44 | $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 $2,884.03 Median $3,981.07 Typical High $6,918.31 | Professional | None | $2,884.03 | $3,981.07 | $6,918.31 |
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 $1,071.52 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,071.52 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $524.81 Typical High $537.03 | Professional | 53 · Discontinued | $426.58 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,949.84 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,621.81 | $1,949.84 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $323.59 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $213.80 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,819.70 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,819.70 | $1,862.09 |
Where Missouri sits
The same service costs 12.3 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 $35,907WA $2,929
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.