How much rates vary
Facilitymedian $10,233 · 10th to 90th $692 to $25,704Professionalmedian $339 · 10th to 90th $234 to $490
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 $239.88 Median $3,467.37 Typical High $5,011.87 | Facility | None | $239.88 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $281.84 | Professional | None | $239.88 | $239.88 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $16,595.87 Typical High $27,542.29 | Facility | None | $2,238.72 | $16,595.87 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $478.63 | Professional | None | $213.80 | $354.81 | $478.63 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $134.90 Median $223.87 Typical High $302.00 | Professional | 62 · Two surgeons | $134.90 | $223.87 | $302.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $34.67 Median $57.54 Typical High $81.28 | Professional | 80 · Assistant surgeon | $34.67 | $57.54 | $81.28 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $30.20 Median $50.12 Typical High $67.61 | Professional | AS · PA/NP assist | $30.20 | $50.12 | $67.61 |
CareSource Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Facility | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $549.54 | Professional | None | $269.15 | $331.13 | $549.54 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $2,187.76 | Facility | None | $537.03 | $691.83 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $501.19 | Professional | None | $263.03 | $331.13 | $501.19 |
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 $245.47 Median $309.03 Typical High $512.86 | Professional | None | $245.47 | $309.03 | $512.86 |
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 $120.23 Median $120.23 Typical High $138.04 | Professional | 52 · Reduced service | $120.23 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $47.86 Typical High $56.23 | Professional | 53 · Discontinued | $47.86 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $181.97 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $28.18 |
Where Indiana sits
The same service costs 32.0 times more in Maine than in Montana. 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 $26,674MT $834
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.