How much rates vary
Facilitymedian $3,715 · 10th to 90th $631 to $12,303Professionalmedian $2,951 · 10th to 90th $2,138 to $7,943
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 $5,623.41 Typical High $8,511.38 | Facility | None | $2,344.23 | $5,623.41 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,905.46 | $2,290.87 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $6,025.60 Typical High $16,218.10 | Facility | None | $1,412.54 | $6,025.60 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $3,890.45 | Professional | None | $2,290.87 | $2,691.53 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,698.24 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,445.44 | $1,698.24 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $436.52 Typical High $630.96 | Professional | 80 · Assistant surgeon | $371.54 | $436.52 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $380.19 Typical High $549.54 | Professional | AS · PA/NP assist | $323.59 | $380.19 | $549.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,187.76 Median $2,344.23 Typical High $3,090.30 | Professional | None | $2,187.76 | $2,344.23 | $3,090.30 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $4,466.84 | Professional | None | $1,905.46 | $2,511.89 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $3,019.95 Typical High $10,964.78 | Facility | None | $562.34 | $3,019.95 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $2,398.83 Median $4,168.69 Typical High $16,218.10 | Professional | None | $2,398.83 | $4,168.69 | $16,218.10 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,344.23 Typical High $10,964.78 | Facility | None | $467.74 | $2,344.23 | $10,964.78 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $3,548.13 Typical High $4,786.30 | Professional | None | $2,041.74 | $3,548.13 | $4,786.30 |
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 $954.99 Median $1,122.02 Typical High $1,174.90 | Professional | 52 · Reduced service | $954.99 | $1,122.02 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $446.68 Typical High $467.74 | Professional | 53 · Discontinued | $380.19 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,698.24 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,445.44 | $1,698.24 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $338.84 Typical High $354.81 | Professional | 55 · Aftercare only | $288.40 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $223.87 Typical High $234.42 | Professional | 56 · Pre-op care only | $190.55 | $223.87 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,584.89 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,584.89 | $1,659.59 |
Where Missouri 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.