How much rates vary
Facilitymedian $4,571 · 10th to 90th $676 to $13,490Professionalmedian $2,692 · 10th to 90th $1,698 to $4,571
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 $1,737.80 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,737.80 | $2,630.27 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $12,022.64 Typical High $14,125.38 | Facility | None | $2,884.03 | $12,022.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $3,388.44 Typical High $4,570.88 | Professional | None | $1,737.80 | $3,388.44 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $2,137.96 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,096.48 | $2,137.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $549.54 Typical High $724.44 | Professional | 80 · Assistant surgeon | $275.42 | $549.54 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $478.63 Typical High $645.65 | Professional | AS · PA/NP assist | $245.47 | $478.63 | $645.65 |
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 $1,862.09 Median $2,398.83 Typical High $3,801.89 | Professional | None | $1,862.09 | $2,398.83 | $3,801.89 |
ConnectiCare Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,570.40 | $2,884.03 |
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 $1,584.89 Median $2,570.40 Typical High $6,165.95 | Professional | None | $1,584.89 | $2,570.40 | $6,165.95 |
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 $870.96 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $870.96 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $346.74 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,288.25 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $257.04 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $173.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,862.09 | $1,862.09 |
Where Connecticut sits
The same service costs 7.6 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 $18,140MD $2,382
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.