How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $17,378Professionalmedian $1,905 · 10th to 90th $1,148 to $2,818
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 $1,318.26 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,318.26 | $2,137.96 | $2,137.96 |
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 $1,096.48 Median $1,819.70 Typical High $2,691.53 | Professional | None | $1,096.48 | $1,819.70 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $1,096.48 Typical High $1,659.59 | Professional | 62 · Two surgeons | $676.08 | $1,096.48 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $281.84 Typical High $426.58 | Professional | 80 · Assistant surgeon | $173.78 | $281.84 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $245.47 Typical High $371.54 | Professional | AS · PA/NP assist | $151.36 | $245.47 | $371.54 |
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 $1,621.81 Median $1,905.46 Typical High $2,818.38 | Professional | None | $1,621.81 | $1,905.46 | $2,818.38 |
ConnectiCare Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,041.74 | Professional | None | $1,905.46 | $1,905.46 | $2,041.74 |
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 $1,122.02 Median $1,659.59 Typical High $3,235.94 | Professional | None | $1,122.02 | $1,659.59 | $3,235.94 |
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 $660.69 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $660.69 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $263.03 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,000.00 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $199.53 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $131.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $933.25 | $1,479.11 | $1,479.11 |
Where Connecticut sits
The same service costs 15.8 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 $28,537WA $1,809
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.