How much rates vary
Facilitymedian $3,802 · 10th to 90th $631 to $12,303Professionalmedian $2,754 · 10th to 90th $2,042 to $6,918
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 $2,238.72 Median $5,623.41 Typical High $8,511.38 | Facility | None | $2,238.72 | $5,623.41 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,398.83 | Professional | None | $1,819.70 | $2,187.76 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $6,025.60 Typical High $16,218.10 | Facility | None | $1,412.54 | $6,025.60 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $3,715.35 | Professional | None | $2,137.96 | $2,570.40 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,621.81 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,348.96 | $1,621.81 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $416.87 Typical High $588.84 | Professional | 80 · Assistant surgeon | $346.74 | $416.87 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $363.08 Typical High $512.86 | Professional | AS · PA/NP assist | $302.00 | $363.08 | $512.86 |
BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,290.87 Typical High $3,019.95 | Professional | None | $2,137.96 | $2,290.87 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $741.31 Typical High $2,691.53 | Facility | None | $489.78 | $741.31 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $4,168.69 | Professional | None | $1,862.09 | $2,454.71 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $2,884.03 Typical High $11,481.54 | Facility | None | $562.34 | $2,884.03 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $2,238.72 Median $3,981.07 Typical High $15,488.17 | Professional | None | $2,238.72 | $3,981.07 | $15,488.17 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,344.23 Typical High $11,220.18 | Facility | None | $467.74 | $2,344.23 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $3,388.44 Typical High $4,570.88 | Professional | None | $1,949.84 | $3,388.44 | $4,570.88 |
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 $912.01 Median $1,071.52 Typical High $1,122.02 | Professional | 52 · Reduced service | $912.01 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $436.52 Typical High $446.68 | Professional | 53 · Discontinued | $363.08 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,621.81 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,380.38 | $1,621.81 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $323.59 Typical High $338.84 | Professional | 55 · Aftercare only | $275.42 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $218.78 Typical High $223.87 | Professional | 56 · Pre-op care only | $181.97 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,513.56 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,513.56 | $1,584.89 |
Where Missouri 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 $34,990TX $2,527
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.