How much rates vary
Facilitymedian $977 · 10th to 90th $501 to $6,761Professionalmedian $1,380 · 10th to 90th $977 to $2,570
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 $1,000.00 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,000.00 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,023.29 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,023.29 | $2,187.76 |
Ambetter Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | AS · PA/NP assist | $295.12 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $1,819.70 Typical High $7,762.47 | Facility | None | $588.84 | $1,819.70 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,412.54 Typical High $2,454.71 | Professional | None | $954.99 | $1,412.54 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $933.25 Typical High $1,621.81 | Professional | 62 · Two surgeons | $630.96 | $933.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $251.19 Typical High $407.38 | Professional | 80 · Assistant surgeon | $158.49 | $251.19 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $204.17 Typical High $354.81 | Professional | AS · PA/NP assist | $141.25 | $204.17 | $354.81 |
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 $1,174.90 Median $1,698.24 Typical High $3,019.95 | Professional | None | $1,174.90 | $1,698.24 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $2,818.38 | Professional | None | $1,023.29 | $1,258.93 | $2,818.38 |
Oscar Health Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
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 $1,023.29 Median $1,479.11 Typical High $3,090.30 | Professional | None | $1,023.29 | $1,479.11 | $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 $501.19 Median $501.19 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $501.19 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $234.42 | Professional | 53 · Discontinued | $199.53 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $870.96 | Professional | 54 · Surgery only | $758.58 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $173.78 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $812.83 |
Where Georgia sits
The same service costs 9.8 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 $16,204MD $1,659
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.