How much rates vary
Facilitymedian $1,549 · 10th to 90th $513 to $11,220Professionalmedian $2,570 · 10th to 90th $1,738 to $4,571
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 $1,862.09 Median $5,370.32 Typical High $7,943.28 | Facility | None | $1,862.09 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Professional | None | $1,862.09 | $1,862.09 | $2,187.76 |
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 $1,621.81 Median $2,570.40 Typical High $4,265.80 | Professional | None | $1,621.81 | $2,570.40 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,621.81 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,148.15 | $1,621.81 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $446.68 Typical High $724.44 | Professional | 80 · Assistant surgeon | $295.12 | $446.68 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $363.08 Typical High $616.60 | Professional | AS · PA/NP assist | $257.04 | $363.08 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $549.54 Typical High $2,398.83 | Facility | None | $501.19 | $549.54 | $2,398.83 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $3,019.95 Typical High $5,248.07 | Professional | None | $2,137.96 | $3,019.95 | $5,248.07 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,995.26 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,454.71 | $3,715.35 |
Oscar Health Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 $1,584.89 Median $2,691.53 Typical High $5,011.87 | Professional | None | $1,584.89 | $2,691.53 | $5,011.87 |
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 $933.25 Median $933.25 Typical High $1,096.48 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $436.52 | Professional | 53 · Discontinued | $371.54 | $371.54 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $323.59 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,513.56 |
Where Georgia sits
The same service costs 14.4 times more in Maine than in Maryland. 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 $34,547MD $2,395
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.