How much rates vary
Facilitymedian $7,413 · 10th to 90th $891 to $19,055Professionalmedian $1,660 · 10th to 90th $1,096 to $2,344
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 $1,412.54 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,412.54 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,412.54 Typical High $1,584.89 | Professional | None | $1,288.25 | $1,412.54 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $10,964.78 Typical High $22,387.21 | Facility | None | $1,862.09 | $10,964.78 | $22,387.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,047.13 | $1,737.80 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,548.82 Median $2,630.27 Typical High $3,548.13 | Professional | 50 · Both sides | $1,548.82 | $2,630.27 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $1,096.48 Typical High $1,479.11 | Professional | 62 · Two surgeons | $660.69 | $1,096.48 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $281.84 Typical High $416.87 | Professional | 80 · Assistant surgeon | $165.96 | $281.84 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $245.47 Typical High $331.13 | Professional | AS · PA/NP assist | $144.54 | $245.47 | $331.13 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $2,691.53 | Facility | None | $575.44 | $1,737.80 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,513.56 | $2,511.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,235.94 | Facility | None | $912.01 | $2,290.87 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,288.25 | $1,548.82 | $2,089.30 |
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 $1,202.26 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,737.80 | $2,511.89 |
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 $645.65 Median $707.95 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $707.95 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $281.84 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $141.25 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $977.24 | $1,122.02 |
Where Indiana sits
The same service costs 8.1 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 $15,945MD $1,975
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.