How much rates vary
Facilitymedian $6,166 · 10th to 90th $759 to $19,498Professionalmedian $1,905 · 10th to 90th $1,122 to $2,692
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 $7,585.78 Typical High $9,772.37 | Facility | None | $4,365.16 | $7,585.78 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,606.93 Median $16,982.44 Typical High $22,387.21 | Facility | None | $6,606.93 | $16,982.44 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,905.46 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,818.38 Typical High $3,981.07 | Professional | 50 · Both sides | $1,659.59 | $2,818.38 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $302.00 Typical High $426.58 | Professional | 80 · Assistant surgeon | $177.83 | $302.00 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $263.03 Typical High $371.54 | Professional | AS · PA/NP assist | $154.88 | $263.03 | $371.54 |
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 $1,348.96 Median $1,862.09 Typical High $2,951.21 | Professional | None | $1,348.96 | $1,862.09 | $2,951.21 |
ConnectiCare Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,737.80 | $1,737.80 | $2,089.30 |
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 $1,202.26 Median $1,949.84 Typical High $3,890.45 | Professional | None | $1,202.26 | $1,949.84 | $3,890.45 |
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 $616.60 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $616.60 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $251.19 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $933.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $186.21 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $123.03 | $186.21 | $186.21 |
Where Connecticut sits
The same service costs 15.0 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 $27,402MD $1,821
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.