How much rates vary
Facilitymedian $6,026 · 10th to 90th $501 to $23,442Professionalmedian $1,380 · 10th to 90th $182 to $2,188
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 $1,445.44 Median $10,232.93 Typical High $13,803.84 | Facility | None | $1,445.44 | $10,232.93 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $7,244.36 | Professional | None | $1,445.44 | $1,445.44 | $7,244.36 |
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 $1,096.48 Median $1,380.38 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,380.38 | $2,398.83 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,047.13 Typical High $6,760.83 | Facility | None | $426.58 | $1,047.13 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,089.30 | $2,754.23 |
Medical Mutual of Ohio Setting Facility Modifier None Typical Low $426.58 Median $1,122.02 Typical High $6,760.83 | Facility | None | $426.58 | $1,122.02 | $6,760.83 |
Medical Mutual of Ohio Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,698.24 | $2,089.30 | $2,754.23 |
Molina Setting Professional Modifier None Typical Low $165.96 Median $1,174.90 Typical High $1,995.26 | Professional | None | $165.96 | $1,174.90 | $1,995.26 |
SummaCare Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,089.30 | Professional | None | $1,445.44 | $1,621.81 | $2,089.30 |
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 $1,000.00 Median $1,659.59 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,659.59 | $2,884.03 |
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 $724.44 Median $724.44 Typical High $3,090.30 | Professional | 52 · Reduced service | $724.44 | $724.44 | $3,090.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $1,258.93 | Professional | 53 · Discontinued | $288.40 | $288.40 | $1,258.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $4,677.35 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $4,677.35 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $933.25 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $933.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $630.96 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $630.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $4,365.16 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $870.96 Typical High $1,513.56 | Professional | 62 · Two surgeons | $691.83 | $870.96 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $223.87 Typical High $389.05 | Professional | 80 · Assistant surgeon | $177.83 | $223.87 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $194.98 Typical High $338.84 | Professional | AS · PA/NP assist | $154.88 | $194.98 | $338.84 |
Where Ohio sits
The same service costs 15.3 times more in Maine than in Delaware. 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 $34,309DE $2,240
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.