How much rates vary
Facilitymedian $25,704 · 10th to 90th $1,318 to $26,915Professionalmedian $1,445 · 10th to 90th $1,096 to $2,089
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,318.26 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $20,892.96 Median $26,915.35 Typical High $27,542.29 | Facility | None | $20,892.96 | $26,915.35 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,513.56 Typical High $2,238.72 | Professional | None | $1,071.52 | $1,513.56 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $223.87 Typical High $338.84 | Professional | 80 · Assistant surgeon | $169.82 | $223.87 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $194.98 Typical High $295.12 | Professional | AS · PA/NP assist | $151.36 | $194.98 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $707.95 Typical High $16,595.87 | Facility | None | $151.36 | $707.95 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,584.89 | $2,398.83 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,445.44 | $2,137.96 |
Martin's Point Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,318.26 | $1,905.46 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,548.82 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,548.82 | $2,187.76 |
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 $891.25 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $891.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $831.76 | $933.25 | $933.25 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $954.99 | $1,000.00 | $1,000.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $891.25 | $933.25 | $933.25 |
Where Maine 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.