How much rates vary
Facilitymedian $10,471 · 10th to 90th $832 to $22,909Professionalmedian $1,514 · 10th to 90th $1,047 to $2,239
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 $1,174.90 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,174.90 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,174.90 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $15,135.61 Typical High $24,547.09 | Facility | None | $1,862.09 | $15,135.61 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,698.24 Typical High $2,238.72 | Professional | None | $954.99 | $1,698.24 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $1,047.13 Typical High $1,412.54 | Professional | 62 · Two surgeons | $602.56 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $269.15 Typical High $380.19 | Professional | 80 · Assistant surgeon | $154.88 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $234.42 Typical High $316.23 | Professional | AS · PA/NP assist | $134.90 | $234.42 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,398.83 | Professional | None | $1,202.26 | $1,479.11 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,090.30 | Facility | None | $912.01 | $2,290.87 | $3,090.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,548.82 | $2,137.96 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,380.38 | $2,089.30 |
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 $588.84 Median $588.84 Typical High $676.08 | Professional | 52 · Reduced service | $588.84 | $588.84 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 53 · Discontinued | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $891.25 Typical High $1,023.29 | Professional | 54 · Surgery only | $870.96 | $891.25 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $204.17 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $831.76 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $812.83 | $831.76 | $954.99 |
Where Indiana 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.