How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,000Professionalmedian $1,698 · 10th to 90th $1,148 to $3,802
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 $1,380.38 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,380.38 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,412.54 | Professional | None | $954.99 | $1,148.15 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,000.00 | Facility | None | $1,412.54 | $3,801.89 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,659.59 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,047.13 Typical High $1,380.38 | Professional | 62 · Two surgeons | $724.44 | $1,047.13 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $275.42 Typical High $354.81 | Professional | 80 · Assistant surgeon | $199.53 | $275.42 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $229.09 Typical High $309.03 | Professional | AS · PA/NP assist | $162.18 | $229.09 | $309.03 |
BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,230.27 Typical High $1,737.80 | Professional | None | $1,122.02 | $1,230.27 | $1,737.80 |
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 $1,202.26 Median $1,318.26 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,318.26 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,288.25 Typical High $10,964.78 | Facility | None | $54.95 | $1,288.25 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,570.40 Typical High $11,220.18 | Professional | None | $1,348.96 | $2,570.40 | $11,220.18 |
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 $1,258.93 Median $1,737.80 Typical High $3,090.30 | Professional | None | $1,258.93 | $1,737.80 | $3,090.30 |
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 $478.63 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $478.63 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $229.09 Typical High $234.42 | Professional | 53 · Discontinued | $190.55 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $870.96 Typical High $891.25 | Professional | 54 · Surgery only | $724.44 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $173.78 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $114.82 Typical High $117.49 | Professional | 56 · Pre-op care only | $95.50 | $114.82 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $812.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $676.08 | $812.83 | $831.76 |
Where Missouri sits
The same service costs 8.8 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 $16,376MD $1,851
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.