How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $14,454Professionalmedian $1,820 · 10th to 90th $1,072 to $2,754
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 $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $12,589.25 Typical High $16,218.10 | Facility | None | $3,630.78 | $12,589.25 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,778.28 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,691.53 Typical High $3,890.45 | Professional | 50 · Both sides | $1,584.89 | $2,691.53 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $1,122.02 Typical High $1,621.81 | Professional | 62 · Two surgeons | $660.69 | $1,122.02 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $288.40 Typical High $416.87 | Professional | 80 · Assistant surgeon | $169.82 | $288.40 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $251.19 Typical High $363.08 | Professional | AS · PA/NP assist | $147.91 | $251.19 | $363.08 |
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 $1,288.25 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,288.25 | $1,778.28 | $2,754.23 |
ConnectiCare Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,995.26 | Professional | None | $1,862.09 | $1,862.09 | $1,995.26 |
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 $1,148.15 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,148.15 | $1,819.70 | $3,715.35 |
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 $602.56 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $602.56 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $239.88 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $891.25 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $177.83 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $120.23 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $831.76 | $1,258.93 | $1,258.93 |
Where Connecticut sits
The same service costs 8.5 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 $15,710MD $1,851
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.