How much rates vary
Facilitymedian $1,995 · 10th to 90th $457 to $13,490Professionalmedian $1,820 · 10th to 90th $1,479 to $2,754
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 $1,513.56 Median $1,778.28 Typical High $1,905.46 | Facility | None | $1,513.56 | $1,778.28 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,621.81 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,244.36 Median $10,715.19 Typical High $19,498.45 | Facility | None | $7,244.36 | $10,715.19 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,122.02 Typical High $1,513.56 | Professional | 62 · Two surgeons | $933.25 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $288.40 Typical High $380.19 | Professional | 80 · Assistant surgeon | $239.88 | $288.40 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $251.19 Typical High $331.13 | Professional | AS · PA/NP assist | $208.93 | $251.19 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,691.53 | Facility | None | $1,445.44 | $1,737.80 | $2,691.53 |
CareSource Setting Professional Modifier None Typical Low $1,698.24 Median $2,238.72 Typical High $2,691.53 | Professional | None | $1,698.24 | $2,238.72 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $512.86 Typical High $3,019.95 | Facility | None | $34.67 | $512.86 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,344.23 Typical High $10,000.00 | Professional | None | $1,737.80 | $2,344.23 | $10,000.00 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $912.01 | Professional | None | $33.11 | $33.11 | $912.01 |
United Setting Facility Modifier None Typical Low $354.81 Median $912.01 Typical High $8,317.64 | Facility | None | $354.81 | $912.01 | $8,317.64 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,290.87 Typical High $3,162.28 | Professional | None | $1,698.24 | $2,290.87 | $3,162.28 |
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 $758.58 Median $812.83 Typical High $954.99 | Professional | 52 · Reduced service | $758.58 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $331.13 Typical High $380.19 | Professional | 53 · Discontinued | $302.00 | $331.13 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $288.40 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $162.18 Typical High $190.55 | Professional | 56 · Pre-op care only | $151.36 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,348.96 |
Where Kentucky 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.