How much rates vary
Facilitymedian $6,166 · 10th to 90th $759 to $19,498Professionalmedian $1,318 · 10th to 90th $776 to $1,862
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 $7,413.10 Typical High $10,471.29 | Facility | None | $4,570.88 | $7,413.10 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $1,548.82 | Professional | None | $776.25 | $1,318.26 | $1,548.82 |
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 $758.58 Median $1,288.25 Typical High $1,778.28 | Professional | None | $758.58 | $1,288.25 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $208.93 Typical High $295.12 | Professional | 80 · Assistant surgeon | $123.03 | $208.93 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $181.97 Typical High $257.04 | Professional | AS · PA/NP assist | $107.15 | $181.97 | $257.04 |
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 $933.25 Median $1,288.25 Typical High $1,995.26 | Professional | None | $933.25 | $1,288.25 | $1,995.26 |
ConnectiCare Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,445.44 | Professional | None | $1,230.27 | $1,230.27 | $1,445.44 |
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 $831.76 Median $1,380.38 Typical High $2,754.23 | Professional | None | $831.76 | $1,380.38 | $2,754.23 |
6 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 $426.58 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $426.58 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $169.82 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $645.65 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $128.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $85.11 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $602.56 | $912.01 | $912.01 |
Where Connecticut sits
The same service costs 18.7 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 $26,826MD $1,433
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.