How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,096 to $22,387Professionalmedian $3,020 · 10th to 90th $1,820 to $4,786
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 $1,819.70 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,819.70 | $2,754.23 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $16,595.87 Typical High $25,703.96 | Facility | None | $2,884.03 | $16,595.87 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $3,548.13 Typical High $4,786.30 | Professional | None | $1,995.26 | $3,548.13 | $4,786.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $2,238.72 Typical High $3,019.95 | Professional | 62 · Two surgeons | $1,258.93 | $2,238.72 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $323.59 Median $575.44 Typical High $776.25 | Professional | 80 · Assistant surgeon | $323.59 | $575.44 | $776.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $501.19 Typical High $676.08 | Professional | AS · PA/NP assist | $281.84 | $501.19 | $676.08 |
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 $2,238.72 Median $2,570.40 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,570.40 | $4,073.80 |
ConnectiCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $3,019.95 | Professional | None | $2,187.76 | $2,691.53 | $3,019.95 |
Health New England Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | None | $416.87 | $416.87 | $416.87 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,884.03 Typical High $6,456.54 | Professional | None | $1,659.59 | $2,884.03 | $6,456.54 |
4 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 54 · Surgery only Typical Low $1,348.96 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,348.96 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $269.15 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $181.97 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,905.46 | $1,905.46 |
Where Connecticut sits
The same service costs 7.2 times more in Maine than in Delaware. 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 $28,702DE $3,966
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.