How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $1,479 · 10th to 90th $209 to $2,399
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 $10,232.93 Typical High $13,803.84 | Facility | None | $1,380.38 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $7,762.47 | Professional | None | $1,380.38 | $1,380.38 | $7,762.47 |
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 $1,174.90 Median $1,548.82 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,548.82 | $2,884.03 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,995.26 | $3,235.94 |
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 $1,445.44 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,445.44 | $1,995.26 | $3,235.94 |
Molina Setting Professional Modifier None Typical Low $199.53 Median $1,348.96 Typical High $2,137.96 | Professional | None | $199.53 | $1,348.96 | $2,137.96 |
SummaCare Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,548.82 | $1,548.82 | $2,290.87 |
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 $1,445.44 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,445.44 | $1,949.84 | $3,801.89 |
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 $691.83 Median $691.83 Typical High $3,235.94 | Professional | 52 · Reduced service | $691.83 | $691.83 | $3,235.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,288.25 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,288.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $4,786.30 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $4,786.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $954.99 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $954.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $645.65 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $645.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $4,466.84 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $977.24 Typical High $1,778.28 | Professional | 62 · Two surgeons | $741.31 | $977.24 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $251.19 Typical High $467.74 | Professional | 80 · Assistant surgeon | $186.21 | $251.19 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $218.78 Typical High $398.11 | Professional | AS · PA/NP assist | $162.18 | $218.78 | $398.11 |
Where Ohio 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.