How much rates vary
Facilitymedian $6,310 · 10th to 90th $759 to $31,623Professionalmedian $2,455 · 10th to 90th $1,479 to $3,548
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 $4,570.88 Median $8,511.38 Typical High $11,481.54 | Facility | None | $4,570.88 | $8,511.38 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $2,691.53 | Professional | None | $1,479.11 | $2,511.89 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $26,915.35 Typical High $44,668.36 | Facility | None | $7,585.78 | $26,915.35 | $44,668.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $2,454.71 Typical High $3,388.44 | Professional | None | $1,445.44 | $2,454.71 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $398.11 Typical High $562.34 | Professional | 80 · Assistant surgeon | $234.42 | $398.11 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $346.74 Typical High $489.78 | Professional | AS · PA/NP assist | $204.17 | $346.74 | $489.78 |
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 $1,778.28 Median $2,454.71 Typical High $3,801.89 | Professional | None | $1,778.28 | $2,454.71 | $3,801.89 |
ConnectiCare Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,344.23 | $2,754.23 |
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 $1,584.89 Median $2,630.27 Typical High $5,128.61 | Professional | None | $1,584.89 | $2,630.27 | $5,128.61 |
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 $812.83 Median $1,258.93 Typical High $1,258.93 | Professional | 52 · Reduced service | $812.83 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $501.19 Typical High $501.19 | Professional | 53 · Discontinued | $323.59 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,862.09 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,230.27 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $245.47 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $162.18 | $251.19 | $251.19 |
Where Connecticut sits
The same service costs 24.1 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 $53,525MD $2,222
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.