How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $17,378Professionalmedian $3,467 · 10th to 90th $2,042 to $5,248
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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $4,073.80 Typical High $4,073.80 | Professional | None | $2,398.83 | $4,073.80 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $15,135.61 Typical High $23,442.29 | Facility | None | $6,918.31 | $15,135.61 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $3,388.44 Typical High $4,897.79 | Professional | None | $2,041.74 | $3,388.44 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $2,041.74 Typical High $3,090.30 | Professional | 62 · Two surgeons | $1,288.25 | $2,041.74 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $512.86 Typical High $776.25 | Professional | 80 · Assistant surgeon | $323.59 | $512.86 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $457.09 Typical High $676.08 | Professional | AS · PA/NP assist | $281.84 | $457.09 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,467.37 Typical High $5,128.61 | Professional | None | $2,570.40 | $3,467.37 | $5,128.61 |
ConnectiCare Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,801.89 | Professional | None | $3,548.13 | $3,548.13 | $3,801.89 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $6,025.60 | Professional | None | $2,041.74 | $2,884.03 | $6,025.60 |
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 $1,202.26 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,202.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $478.63 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $1,778.28 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $363.08 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $239.88 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,818.38 | $2,818.38 |
Where Connecticut sits
The same service costs 11.5 times more in Maine than in Washington. 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 $29,935WA $2,608
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.