How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $11,482Professionalmedian $2,188 · 10th to 90th $1,479 to $4,074
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 $1,548.82 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,548.82 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,548.82 | $2,238.72 |
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 $1,412.54 Median $2,187.76 Typical High $3,715.35 | Professional | None | $1,412.54 | $2,187.76 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,380.38 Typical High $2,398.83 | Professional | 62 · Two surgeons | $977.24 | $1,380.38 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $371.54 Typical High $645.65 | Professional | 80 · Assistant surgeon | $251.19 | $371.54 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $309.03 Typical High $549.54 | Professional | AS · PA/NP assist | $218.78 | $309.03 | $549.54 |
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 $1,778.28 Median $2,570.40 Typical High $5,128.61 | Professional | None | $1,778.28 | $2,570.40 | $5,128.61 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $6,918.31 | Professional | None | $1,584.89 | $1,949.84 | $6,918.31 |
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 $1,513.56 Median $2,238.72 Typical High $4,786.30 | Professional | None | $1,513.56 | $2,238.72 | $4,786.30 |
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 $776.25 Median $776.25 Typical High $912.01 | Professional | 52 · Reduced service | $776.25 | $776.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | 53 · Discontinued | $309.03 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,258.93 |
Where Georgia sits
The same service costs 15.5 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 $34,449MD $2,222
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.