How much rates vary
Facilitymedian $5,012 · 10th to 90th $513 to $23,442Professionalmedian $1,380 · 10th to 90th $182 to $2,239
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 $3,715.35 Median $6,606.93 Typical High $12,589.25 | Facility | None | $3,715.35 | $6,606.93 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $8,317.64 | Professional | None | $1,380.38 | $1,380.38 | $8,317.64 |
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 $1,479.11 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,479.11 | $2,344.23 |
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 $1,380.38 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,380.38 | $1,995.26 | $3,311.31 |
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 $1,380.38 Median $1,995.26 Typical High $3,311.31 | Professional | None | $1,380.38 | $1,995.26 | $3,311.31 |
Molina Setting Professional Modifier None Typical Low $162.18 Median $1,230.27 Typical High $1,949.84 | Professional | None | $162.18 | $1,230.27 | $1,949.84 |
SummaCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,445.44 | $2,187.76 |
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 $3,715.35 | Professional | None | $1,445.44 | $1,949.84 | $3,715.35 |
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 $3,630.78 | Professional | 52 · Reduced service | $691.83 | $691.83 | $3,630.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $1,445.44 | Professional | 53 · Discontinued | $275.42 | $275.42 | $1,445.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,023.29 Typical High $5,370.32 | Professional | 54 · Surgery only | $1,023.29 | $1,023.29 | $5,370.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $204.17 Typical High $1,071.52 | Professional | 55 · Aftercare only | $204.17 | $204.17 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $724.44 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $724.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $954.99 Typical High $5,011.87 | Professional | 78 · Unplanned return to OR | $954.99 | $954.99 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $954.99 Typical High $1,513.56 | Professional | 62 · Two surgeons | $741.31 | $954.99 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $239.88 Typical High $389.05 | Professional | 80 · Assistant surgeon | $190.55 | $239.88 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $208.93 Typical High $338.84 | Professional | AS · PA/NP assist | $165.96 | $208.93 | $338.84 |
Where Ohio sits
The same service costs 15.8 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 $34,401WA $2,171
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.