How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $18,621Professionalmedian $1,380 · 10th to 90th $813 to $1,995
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 $851.14 Median $1,122.02 Typical High $1,122.02 | Professional | None | $851.14 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $16,595.87 Typical High $22,908.68 | Facility | None | $6,760.83 | $16,595.87 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $1,380.38 Typical High $1,995.26 | Professional | None | $812.83 | $1,380.38 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $512.86 Median $870.96 Typical High $1,258.93 | Professional | 62 · Two surgeons | $512.86 | $870.96 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $218.78 Typical High $323.59 | Professional | 80 · Assistant surgeon | $128.82 | $218.78 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $190.55 Typical High $281.84 | Professional | AS · PA/NP assist | $114.82 | $190.55 | $281.84 |
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 $1,122.02 Median $1,288.25 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,288.25 | $1,949.84 |
ConnectiCare Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,318.26 | $1,621.81 |
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 $794.33 Median $1,122.02 Typical High $2,454.71 | Professional | None | $794.33 | $1,122.02 | $2,454.71 |
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 $416.87 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $416.87 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $165.96 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $616.60 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $83.18 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $575.44 | $794.33 | $794.33 |
Where Connecticut sits
The same service costs 18.1 times more in Maine than in Arkansas. 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 $27,451AR $1,513
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.