How much rates vary
Facilitymedian $9,772 · 10th to 90th $912 to $25,704Professionalmedian $1,698 · 10th to 90th $1,202 to $2,344
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 $1,318.26 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,318.26 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,318.26 | $1,659.59 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $1,548.82 Typical High $1,778.28 | Professional | None | $208.93 | $1,548.82 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $16,595.87 Typical High $27,542.29 | Facility | None | $2,238.72 | $16,595.87 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,096.48 Typical High $1,479.11 | Professional | 62 · Two surgeons | $758.58 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $281.84 Typical High $398.11 | Professional | 80 · Assistant surgeon | $190.55 | $281.84 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $245.47 Typical High $331.13 | Professional | AS · PA/NP assist | $165.96 | $245.47 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Facility | None | $1,412.54 | $1,412.54 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,584.89 Typical High $2,818.38 | Facility | None | $562.34 | $1,584.89 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,659.59 | $2,344.23 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,630.78 | Facility | None | $912.01 | $2,290.87 | $3,630.78 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,737.80 | $2,630.27 |
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 $1,230.27 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,659.59 | $2,454.71 |
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 $660.69 Typical High $831.76 | Professional | 52 · Reduced service | $660.69 | $660.69 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,000.00 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,000.00 | $1,000.00 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $245.47 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $933.25 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $933.25 | $933.25 | $1,148.15 |
Where Indiana 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.