How much rates vary
Facilitymedian $8,913 · 10th to 90th $1,047 to $23,442Professionalmedian $2,570 · 10th to 90th $347 to $4,074
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 $2,754.23 Median $10,964.78 Typical High $14,791.08 | Facility | None | $2,754.23 | $10,964.78 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $12,589.25 | Professional | None | $2,754.23 | $2,754.23 | $12,589.25 |
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 $2,187.76 Median $2,754.23 Typical High $4,466.84 | Professional | None | $2,187.76 | $2,754.23 | $4,466.84 |
CareSource Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Facility | None | $3,801.89 | $3,801.89 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,202.26 Typical High $6,760.83 | Facility | None | $426.58 | $1,202.26 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $3,090.30 Median $3,981.07 Typical High $5,495.41 | Professional | None | $3,090.30 | $3,981.07 | $5,495.41 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $1,318.26 Typical High $6,760.83 | Facility | None | $426.58 | $1,318.26 | $6,760.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $3,090.30 Median $3,981.07 Typical High $5,495.41 | Professional | None | $3,090.30 | $3,981.07 | $5,495.41 |
Molina Setting Professional Modifier None Typical Low $323.59 Median $2,137.96 Typical High $3,630.78 | Professional | None | $323.59 | $2,137.96 | $3,630.78 |
SummaCare Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $3,890.45 | Professional | None | $2,691.53 | $2,951.21 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $4,570.88 Typical High $13,803.84 | Facility | None | $1,071.52 | $4,570.88 | $13,803.84 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $3,162.28 Typical High $5,623.41 | Professional | None | $1,905.46 | $3,162.28 | $5,623.41 |
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 $1,380.38 Median $1,380.38 Typical High $6,309.57 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $2,511.89 | Professional | 53 · Discontinued | $549.54 | $549.54 | $2,511.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $9,549.93 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $9,549.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $1,905.46 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $1,905.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $1,258.93 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $1,258.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $8,912.51 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,737.80 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,380.38 | $1,737.80 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $436.52 Typical High $707.95 | Professional | 80 · Assistant surgeon | $354.81 | $436.52 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $389.05 Typical High $630.96 | Professional | AS · PA/NP assist | $309.03 | $389.05 | $630.96 |
Where Ohio sits
The same service costs 5.6 times more in Maine than in Utah. 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 $35,990UT $6,433
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.