How much rates vary
Facilitymedian $1,698 · 10th to 90th $457 to $8,913Professionalmedian $1,023 · 10th to 90th $813 to $1,660
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 $812.83 Median $954.99 Typical High $1,047.13 | Facility | None | $812.83 | $954.99 | $1,047.13 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,096.48 | Professional | None | $812.83 | $891.25 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $5,495.41 Typical High $10,964.78 | Facility | None | $3,235.94 | $5,495.41 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,412.54 | Professional | None | $812.83 | $1,000.00 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $630.96 Typical High $870.96 | Professional | 62 · Two surgeons | $512.86 | $630.96 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $158.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $131.83 | $158.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $138.04 Typical High $190.55 | Professional | AS · PA/NP assist | $114.82 | $138.04 | $190.55 |
CareSource Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $1,445.44 | Facility | None | $776.25 | $933.25 | $1,445.44 |
CareSource Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,513.56 | Professional | None | $891.25 | $1,258.93 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $1,698.24 | Facility | None | $34.67 | $691.83 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,445.44 Typical High $12,589.25 | Professional | None | $933.25 | $1,445.44 | $12,589.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,819.70 | Professional | None | $977.24 | $1,258.93 | $1,819.70 |
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 $407.38 Median $446.68 Typical High $524.81 | Professional | 52 · Reduced service | $407.38 | $446.68 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $208.93 | Professional | 53 · Discontinued | $162.18 | $177.83 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $794.33 | Professional | 54 · Surgery only | $616.60 | $660.69 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $158.49 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $104.71 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $741.31 |
Where Kentucky 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.