How much rates vary
Facilitymedian $2,138 · 10th to 90th $457 to $13,490Professionalmedian $1,862 · 10th to 90th $1,549 to $2,951
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 $1,621.81 Median $1,862.09 Typical High $2,137.96 | Facility | None | $1,621.81 | $1,862.09 | $2,137.96 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,737.80 Typical High $2,137.96 | Professional | None | $1,621.81 | $1,737.80 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $10,715.19 Typical High $19,498.45 | Facility | None | $7,244.36 | $10,715.19 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,862.09 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,174.90 Typical High $1,778.28 | Professional | 62 · Two surgeons | $977.24 | $1,174.90 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $302.00 Typical High $446.68 | Professional | 80 · Assistant surgeon | $245.47 | $302.00 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $263.03 Typical High $389.05 | Professional | AS · PA/NP assist | $218.78 | $263.03 | $389.05 |
CareSource Setting Facility Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,884.03 | Facility | None | $1,513.56 | $1,819.70 | $2,884.03 |
CareSource Setting Professional Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,949.84 | $2,398.83 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,162.28 | Facility | None | $34.67 | $691.83 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $11,220.18 | Professional | None | $1,862.09 | $2,454.71 | $11,220.18 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $1,230.27 | Professional | None | $33.11 | $33.11 | $1,230.27 |
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 $1,778.28 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,398.83 | $3,311.31 |
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 $812.83 Median $870.96 Typical High $1,071.52 | Professional | 52 · Reduced service | $812.83 | $870.96 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $354.81 Typical High $426.58 | Professional | 53 · Discontinued | $323.59 | $354.81 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,318.26 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,202.26 | $1,318.26 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $263.03 Typical High $323.59 | Professional | 55 · Aftercare only | $239.88 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $173.78 Typical High $213.80 | Professional | 56 · Pre-op care only | $162.18 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,230.27 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,230.27 | $1,513.56 |
Where Kentucky sits
The same service costs 14.0 times more in Maine than in Texas. 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 $34,704TX $2,477
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.