How much rates vary
Facilitymedian $12,589 · 10th to 90th $891 to $44,668Professionalmedian $1,413 · 10th to 90th $1,072 to $2,138
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 $1,380.38 Median $5,011.87 Typical High $11,220.18 | Facility | None | $1,380.38 | $5,011.87 | $11,220.18 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,513.56 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $30,199.52 Typical High $48,977.88 | Facility | None | $2,570.40 | $30,199.52 | $48,977.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,071.52 | $1,258.93 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $204.17 Typical High $316.23 | Professional | 80 · Assistant surgeon | $173.78 | $204.17 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $177.83 Typical High $269.15 | Professional | AS · PA/NP assist | $151.36 | $177.83 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,584.89 Typical High $10,964.78 | Facility | None | $575.44 | $1,584.89 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,659.59 | $2,137.96 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,698.24 Typical High $3,388.44 | Facility | None | $912.01 | $1,698.24 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,288.25 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,621.81 | $2,511.89 |
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 $1,288.25 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,905.46 | $2,754.23 |
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 $758.58 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $302.00 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $302.00 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,148.15 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,023.29 | $1,148.15 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $229.09 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $151.36 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $151.36 | $169.82 |
Where Indiana 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 $53,236MD $2,076
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.