How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $1,995 · 10th to 90th $263 to $3,090
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 $2,089.30 Median $10,715.19 Typical High $13,803.84 | Facility | None | $2,089.30 | $10,715.19 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $9,772.37 | Professional | None | $2,089.30 | $2,089.30 | $9,772.37 |
Ambetter Setting Professional Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,019.95 | Professional | None | $3,019.95 | $3,019.95 | $3,019.95 |
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 $1,659.59 Median $2,089.30 Typical High $3,548.13 | Professional | None | $1,659.59 | $2,089.30 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $363.08 Typical High $1,659.59 | Professional | 80 · Assistant surgeon | $269.15 | $363.08 | $1,659.59 |
CareSource Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna 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 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $4,168.69 | Professional | None | $2,398.83 | $3,019.95 | $4,168.69 |
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 $2,398.83 Median $3,019.95 Typical High $4,168.69 | Professional | None | $2,398.83 | $3,019.95 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $1,621.81 Typical High $2,754.23 | Professional | None | $239.88 | $1,621.81 | $2,754.23 |
SummaCare Setting Professional Modifier None Typical Low $2,041.74 Median $2,290.87 Typical High $2,951.21 | Professional | None | $2,041.74 | $2,290.87 | $2,951.21 |
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 $2,454.71 Typical High $4,265.80 | Professional | None | $1,445.44 | $2,454.71 | $4,265.80 |
8 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 $1,047.13 Median $1,047.13 Typical High $4,897.79 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $1,949.84 | Professional | 53 · Discontinued | $416.87 | $416.87 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $7,413.10 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $1,479.11 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $977.24 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $977.24 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $6,918.31 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $6,918.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,318.26 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,047.13 | $1,318.26 | $2,238.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $288.40 Typical High $501.19 | Professional | AS · PA/NP assist | $234.42 | $288.40 | $501.19 |
Where Ohio 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.