How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $1,862 · 10th to 90th $1,479 to $4,571
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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,548.82 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,698.24 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,071.52 Typical High $1,778.28 | Professional | 62 · Two surgeons | $912.01 | $1,071.52 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $446.68 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $389.05 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,479.11 | $1,659.59 | $2,344.23 |
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 $1,584.89 Median $1,737.80 Typical High $3,388.44 | Professional | None | $1,584.89 | $1,737.80 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $3,388.44 Typical High $10,964.78 | Professional | None | $1,778.28 | $3,388.44 | $10,964.78 |
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 $1,659.59 Median $2,290.87 Typical High $4,168.69 | Professional | None | $1,659.59 | $2,290.87 | $4,168.69 |
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 $645.65 Median $776.25 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $776.25 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $309.03 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $309.03 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,148.15 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,148.15 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $229.09 Typical High $234.42 | Professional | 55 · Aftercare only | $190.55 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $154.88 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,071.52 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,071.52 | $1,096.48 |
Where Missouri 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.