How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,148 to $10,000Professionalmedian $1,820 · 10th to 90th $1,479 to $2,818
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 $1,819.70 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,995.26 | $2,041.74 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,548.82 | $1,862.09 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,148.15 Typical High $1,737.80 | Professional | 62 · Two surgeons | $977.24 | $1,148.15 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $295.12 Typical High $446.68 | Professional | 80 · Assistant surgeon | $251.19 | $295.12 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $257.04 Typical High $389.05 | Professional | AS · PA/NP assist | $218.78 | $257.04 | $389.05 |
CDPHP Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,162.28 | Facility | None | $851.14 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $3,715.35 | Professional | None | $1,621.81 | $1,621.81 | $3,715.35 |
Emblem Health Setting Facility Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $6,918.31 | Facility | None | $1,698.24 | $2,344.23 | $6,918.31 |
Emblem Health Setting Professional Modifier None Typical Low $1,819.70 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,819.70 | $2,137.96 | $3,715.35 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,659.59 | $2,570.40 |
MVP Health Care Setting Facility Modifier None Typical Low $1,778.28 Median $4,786.30 Typical High $5,754.40 | Facility | None | $1,778.28 | $4,786.30 | $5,754.40 |
MVP Health Care Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,621.81 | $1,621.81 | $2,884.03 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,819.70 Typical High $2,884.03 | Professional | None | $1,288.25 | $1,819.70 | $2,884.03 |
Univera Setting Facility Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $5,370.32 | Facility | None | $1,230.27 | $1,819.70 | $5,370.32 |
Univera Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,288.25 | $1,659.59 | $2,570.40 |
15 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 $1,000.00 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,000.00 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $398.11 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,513.56 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $302.00 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $199.53 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,445.44 | $1,445.44 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,513.56 Typical High $2,290.87 | Professional | 54 · Surgery only | $933.25 | $1,513.56 | $2,290.87 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $257.04 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $257.04 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $151.36 Typical High $229.09 | Professional | 56 · Pre-op care only | $93.33 | $151.36 | $229.09 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,348.96 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $831.76 | $1,348.96 | $2,089.30 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $1,000.00 Median $1,348.96 Typical High $1,819.70 | Professional | 53 · Discontinued | $1,000.00 | $1,348.96 | $1,819.70 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,513.56 Typical High $2,290.87 | Professional | 54 · Surgery only | $933.25 | $1,513.56 | $2,290.87 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $165.96 Typical High $371.54 | Professional | 55 · Aftercare only | $104.71 | $165.96 | $371.54 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $151.36 Typical High $338.84 | Professional | 56 · Pre-op care only | $93.33 | $151.36 | $338.84 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,348.96 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $831.76 | $1,348.96 | $2,089.30 |
Where New York sits
The same service costs 7.2 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 $18,361MD $2,558
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.