How much rates vary
Facilitymedian $7,413 · 10th to 90th $1,047 to $18,621Professionalmedian $2,291 · 10th to 90th $1,318 to $3,631
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 $4,570.88 Median $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,348.96 | $2,089.30 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $16,218.10 Typical High $22,908.68 | Facility | None | $2,884.03 | $16,218.10 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $2,691.53 Typical High $3,630.78 | Professional | None | $1,288.25 | $2,691.53 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,698.24 Typical High $2,290.87 | Professional | 62 · Two surgeons | $812.83 | $1,698.24 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $426.58 Typical High $575.44 | Professional | 80 · Assistant surgeon | $204.17 | $426.58 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $371.54 Typical High $501.19 | Professional | AS · PA/NP assist | $177.83 | $371.54 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,000.00 Typical High $27,542.29 | Facility | None | $512.86 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,905.46 Typical High $3,019.95 | Professional | None | $1,659.59 | $1,905.46 | $3,019.95 |
ConnectiCare Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,238.72 | Professional | None | $1,621.81 | $2,041.74 | $2,238.72 |
Health New England Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $2,818.38 | Professional | None | $309.03 | $309.03 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $2,187.76 Typical High $4,786.30 | Professional | None | $1,230.27 | $2,187.76 | $4,786.30 |
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 $676.08 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $676.08 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $269.15 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,023.29 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $204.17 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $134.90 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $954.99 | $1,445.44 | $1,445.44 |
Where Connecticut sits
The same service costs 8.5 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 $28,081DE $3,299
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.