How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $11,482Professionalmedian $3,236 · 10th to 90th $2,188 to $6,026
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 $2,344.23 Median $5,370.32 Typical High $7,943.28 | Facility | None | $2,344.23 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $6,165.95 | Professional | None | $2,344.23 | $2,344.23 | $6,165.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $3,162.28 Typical High $16,218.10 | Facility | None | $1,122.02 | $3,162.28 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $3,235.94 Typical High $5,128.61 | Professional | None | $2,041.74 | $3,235.94 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $2,089.30 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,445.44 | $2,089.30 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $562.34 Typical High $912.01 | Professional | 80 · Assistant surgeon | $371.54 | $562.34 | $912.01 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $457.09 Typical High $776.25 | Professional | AS · PA/NP assist | $323.59 | $457.09 | $776.25 |
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 $2,630.27 Median $3,801.89 Typical High $6,456.54 | Professional | None | $2,630.27 | $3,801.89 | $6,456.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,511.89 Median $3,019.95 Typical High $8,511.38 | Professional | None | $2,511.89 | $3,019.95 | $8,511.38 |
Oscar Health Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
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 $1,995.26 Median $3,388.44 Typical High $6,309.57 | Professional | None | $1,995.26 | $3,388.44 | $6,309.57 |
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 $1,148.15 Median $1,148.15 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | 53 · Discontinued | $467.74 | $467.74 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $407.38 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $269.15 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $269.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,905.46 |
Where Georgia sits
The same service costs 13.8 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 $35,114TX $2,545
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.