How much rates vary
Facilitymedian $5,248 · 10th to 90th $501 to $23,442Professionalmedian $1,905 · 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 $2,041.74 Median $10,232.93 Typical High $13,803.84 | Facility | None | $2,041.74 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $8,128.31 | Professional | None | $2,041.74 | $2,041.74 | $8,128.31 |
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 $3,467.37 | Professional | None | $1,659.59 | $2,089.30 | $3,467.37 |
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 $588.84 Typical High $2,691.53 | Facility | None | $426.58 | $588.84 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $4,168.69 | Professional | None | $2,344.23 | $2,951.21 | $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 $2,344.23 Median $2,951.21 Typical High $4,168.69 | Professional | None | $2,344.23 | $2,951.21 | $4,168.69 |
Molina Setting Professional Modifier None Typical Low $239.88 Median $1,584.89 Typical High $2,691.53 | Professional | None | $239.88 | $1,584.89 | $2,691.53 |
SummaCare Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,238.72 | $2,884.03 |
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 $1,412.54 Median $2,398.83 Typical High $4,168.69 | Professional | None | $1,412.54 | $2,398.83 | $4,168.69 |
9 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 $1,023.29 Median $1,023.29 Typical High $3,801.89 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $1,548.82 | Professional | 53 · Discontinued | $416.87 | $416.87 | $1,548.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $5,754.40 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $5,754.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $1,148.15 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $204.17 Typical High $776.25 | Professional | 56 · Pre-op care only | $204.17 | $204.17 | $776.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,445.44 Median $1,445.44 Typical High $5,370.32 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,318.26 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,047.13 | $1,318.26 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $331.13 Typical High $562.34 | Professional | 80 · Assistant surgeon | $263.03 | $331.13 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $288.40 Typical High $489.78 | Professional | AS · PA/NP assist | $234.42 | $288.40 | $489.78 |
Where Ohio 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.