How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $2,399 · 10th to 90th $347 to $3,890
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 $2,398.83 Median $10,715.19 Typical High $13,803.84 | Facility | None | $2,398.83 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $11,220.18 | Professional | None | $2,398.83 | $2,398.83 | $11,220.18 |
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 $2,041.74 Median $2,570.40 Typical High $4,168.69 | Professional | None | $2,041.74 | $2,570.40 | $4,168.69 |
CareSource Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Facility | None | $3,235.94 | $3,235.94 | $3,235.94 |
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 $2,454.71 Median $3,388.44 Typical High $5,623.41 | Professional | None | $2,454.71 | $3,388.44 | $5,623.41 |
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 $2,454.71 Median $3,388.44 Typical High $5,623.41 | Professional | None | $2,454.71 | $3,388.44 | $5,623.41 |
Molina Setting Professional Modifier None Typical Low $316.23 Median $2,137.96 Typical High $3,467.37 | Professional | None | $316.23 | $2,137.96 | $3,467.37 |
SummaCare Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,890.45 | Professional | None | $2,570.40 | $2,570.40 | $3,890.45 |
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 $2,511.89 Median $3,388.44 Typical High $6,456.54 | Professional | None | $2,511.89 | $3,388.44 | $6,456.54 |
9 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 $1,174.90 Median $1,174.90 Typical High $5,623.41 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $5,623.41 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $478.63 Typical High $2,238.72 | Professional | 53 · Discontinued | $478.63 | $478.63 | $2,238.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $8,511.38 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $8,511.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $1,698.24 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $1,698.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $239.88 Typical High $1,122.02 | Professional | 56 · Pre-op care only | $239.88 | $239.88 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $7,943.28 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $7,943.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,621.81 Typical High $2,630.27 | Professional | 62 · Two surgeons | $1,288.25 | $1,621.81 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $416.87 Typical High $660.69 | Professional | 80 · Assistant surgeon | $323.59 | $416.87 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $363.08 Typical High $575.44 | Professional | AS · PA/NP assist | $281.84 | $363.08 | $575.44 |
Where Ohio 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.