How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $28,184Professionalmedian $2,188 · 10th to 90th $1,230 to $3,020
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 $1,174.90 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,174.90 | $2,238.72 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,715.35 Median $26,915.35 Typical High $39,810.72 | Facility | None | $3,715.35 | $26,915.35 | $39,810.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,148.15 | $1,949.84 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $1,230.27 Typical High $1,862.09 | Professional | 62 · Two surgeons | $724.44 | $1,230.27 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $309.03 Typical High $467.74 | Professional | 80 · Assistant surgeon | $181.97 | $309.03 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $269.15 Typical High $416.87 | Professional | AS · PA/NP assist | $158.49 | $269.15 | $416.87 |
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 $1,584.89 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,584.89 | $2,041.74 | $3,019.95 |
ConnectiCare Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,137.96 | Professional | None | $2,089.30 | $2,089.30 | $2,137.96 |
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 $1,288.25 Median $2,290.87 Typical High $4,677.35 | Professional | None | $1,288.25 | $2,290.87 | $4,677.35 |
5 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 $691.83 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $691.83 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $281.84 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,047.13 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $208.93 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $141.25 | $223.87 | $223.87 |
Where Connecticut sits
The same service costs 25.6 times more in Maine than in Maryland. 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 $49,683MD $1,943
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.