How much rates vary
Facilitymedian $10,000 · 10th to 90th $912 to $25,119Professionalmedian $1,175 · 10th to 90th $891 to $1,778
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 $1,288.25 Median $5,011.87 Typical High $9,772.37 | Facility | None | $1,288.25 | $5,011.87 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,288.25 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,630.27 Median $18,197.01 Typical High $27,542.29 | Facility | None | $2,630.27 | $18,197.01 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,621.81 | Professional | None | $851.14 | $1,047.13 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,584.89 Typical High $2,398.83 | Professional | 50 · Both sides | $1,258.93 | $1,584.89 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $169.82 Typical High $263.03 | Professional | 80 · Assistant surgeon | $134.90 | $169.82 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $147.91 Typical High $223.87 | Professional | AS · PA/NP assist | $117.49 | $147.91 | $223.87 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,318.26 Typical High $3,235.94 | Facility | None | $575.44 | $1,318.26 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,380.38 | $1,778.28 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $1,412.54 Typical High $2,884.03 | Facility | None | $912.01 | $1,412.54 | $2,884.03 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,174.90 | $1,412.54 | $1,905.46 |
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 $1,096.48 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,096.48 | $1,584.89 | $2,290.87 |
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 $588.84 Median $645.65 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $257.04 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $144.54 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $144.54 |
Where Indiana 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.