How much rates vary
Facilitymedian $10,965 · 10th to 90th $1,259 to $25,704Professionalmedian $1,380 · 10th to 90th $1,000 to $1,905
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 $1,047.13 Median $1,258.93 Typical High $5,011.87 | Facility | None | $1,047.13 | $1,258.93 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,071.52 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,071.52 | $1,479.11 |
Ambetter Setting Professional Modifier None Typical Low $501.19 Median $1,122.02 Typical High $1,288.25 | Professional | None | $501.19 | $1,122.02 | $1,288.25 |
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 $891.25 Median $1,548.82 Typical High $1,698.24 | Professional | None | $891.25 | $1,548.82 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $251.19 Typical High $309.03 | Professional | 80 · Assistant surgeon | $144.54 | $251.19 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $218.78 Typical High $239.88 | Professional | AS · PA/NP assist | $125.89 | $218.78 | $239.88 |
CareSource Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,148.15 | $1,148.15 | $1,148.15 |
CareSource Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $16,595.87 | Facility | None | $512.86 | $851.14 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,479.11 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $2,884.03 | Facility | None | $912.01 | $2,238.72 | $2,884.03 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,122.02 Median $1,479.11 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,479.11 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $5,495.41 Typical High $14,791.08 | Facility | None | $1,258.93 | $5,495.41 | $14,791.08 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,041.74 | Professional | None | $977.24 | $1,348.96 | $2,041.74 |
2 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 $794.33 Median $794.33 Typical High $1,096.48 | Professional | 54 · Surgery only | $794.33 | $794.33 | $1,096.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $1,023.29 |
Where Indiana sits
The same service costs 8.7 times more in Maine than in Kentucky. 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 $27,149KY $3,127
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.