How much rates vary
Facilitymedian $4,677 · 10th to 90th $759 to $18,621Professionalmedian $2,089 · 10th to 90th $1,413 to $3,236
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 $2,570.40 Median $4,677.35 Typical High $8,128.31 | Facility | None | $2,570.40 | $4,677.35 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,479.11 | $2,570.40 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,235.94 Median $15,848.93 Typical High $21,877.62 | Facility | None | $3,235.94 | $15,848.93 | $21,877.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $2,137.96 Typical High $3,090.30 | Professional | None | $1,348.96 | $2,137.96 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,318.26 Typical High $1,949.84 | Professional | 62 · Two surgeons | $851.14 | $1,318.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $331.13 Typical High $501.19 | Professional | 80 · Assistant surgeon | $213.80 | $331.13 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $288.40 Typical High $436.52 | Professional | AS · PA/NP assist | $186.21 | $288.40 | $436.52 |
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 $1,698.24 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,698.24 | $2,041.74 | $3,162.28 |
ConnectiCare Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,630.27 | Professional | None | $2,290.87 | $2,290.87 | $2,630.27 |
Health New England Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,818.38 | $2,818.38 | $2,818.38 |
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 $1,318.26 Median $1,862.09 Typical High $3,890.45 | Professional | None | $1,318.26 | $1,862.09 | $3,890.45 |
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 $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $758.58 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $309.03 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,148.15 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $380.19 Typical High $380.19 | Professional | 55 · Aftercare only | $229.09 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $154.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,778.28 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,778.28 | $1,778.28 |
Where Connecticut sits
The same service costs 13.5 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 $28,253WA $2,096
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.