How much rates vary
Facilitymedian $2,512 · 10th to 90th $457 to $13,490Professionalmedian $2,239 · 10th to 90th $1,862 to $3,467
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 $1,949.84 Median $2,238.72 Typical High $2,630.27 | Facility | None | $1,949.84 | $2,238.72 | $2,630.27 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,949.84 | $2,089.30 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
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 $1,862.09 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,238.72 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,412.54 Typical High $1,905.46 | Professional | 62 · Two surgeons | $1,174.90 | $1,412.54 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $363.08 Typical High $478.63 | Professional | 80 · Assistant surgeon | $295.12 | $363.08 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $316.23 Typical High $426.58 | Professional | AS · PA/NP assist | $257.04 | $316.23 | $426.58 |
CareSource Setting Facility Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $3,467.37 | Facility | None | $1,819.70 | $2,187.76 | $3,467.37 |
CareSource Setting Professional Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $3,467.37 | Professional | None | $2,137.96 | $2,818.38 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $691.83 Typical High $3,890.45 | Facility | None | $34.67 | $691.83 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,951.21 Typical High $12,882.50 | Professional | None | $2,187.76 | $2,951.21 | $12,882.50 |
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 $2,137.96 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,137.96 | $2,884.03 | $3,981.07 |
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 $977.24 Median $1,047.13 Typical High $1,288.25 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $416.87 Typical High $524.81 | Professional | 53 · Discontinued | $389.05 | $416.87 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,584.89 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,445.44 | $1,584.89 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $316.23 Typical High $389.05 | Professional | 55 · Aftercare only | $288.40 | $316.23 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $263.03 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,479.11 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,479.11 | $1,819.70 |
Where Kentucky sits
The same service costs 12.4 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 $35,178WA $2,843
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.