How much rates vary
Facilitymedian $12,589 · 10th to 90th $891 to $44,668Professionalmedian $2,344 · 10th to 90th $1,778 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 $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 $2,290.87 Median $2,511.89 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,511.89 | $2,818.38 |
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 $1,778.28 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,089.30 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $524.81 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $295.12 Typical High $446.68 | Professional | AS · PA/NP assist | $251.19 | $295.12 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,290.87 Typical High $3,630.78 | Facility | None | $575.44 | $2,290.87 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,754.23 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $5,623.41 | Facility | None | $912.01 | $2,089.30 | $5,623.41 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,715.35 | Professional | None | $2,290.87 | $2,754.23 | $3,715.35 |
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 $2,187.76 Median $3,162.28 Typical High $4,570.88 | Professional | None | $2,187.76 | $3,162.28 | $4,570.88 |
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 $1,148.15 Median $1,258.93 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,148.15 | $1,258.93 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $501.19 Typical High $562.34 | Professional | 53 · Discontinued | $457.09 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,862.09 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,737.80 | $1,862.09 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $380.19 Typical High $426.58 | Professional | 55 · Aftercare only | $346.74 | $380.19 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $251.19 Typical High $281.84 | Professional | 56 · Pre-op care only | $229.09 | $251.19 | $281.84 |
Where Indiana sits
The same service costs 19.3 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 $54,522WA $2,820
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.