How much rates vary
Facilitymedian $8,913 · 10th to 90th $2,344 to $25,704Professionalmedian $2,089 · 10th to 90th $1,380 to $3,388
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 $2,398.83 Median $3,890.45 Typical High $15,848.93 | Facility | None | $2,398.83 | $3,890.45 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,318.26 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $18,197.01 Typical High $28,183.83 | Facility | None | $8,912.51 | $18,197.01 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $2,398.83 Typical High $3,019.95 | Professional | None | $1,348.96 | $2,398.83 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,380.38 Typical High $1,819.70 | Professional | 62 · Two surgeons | $851.14 | $1,380.38 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $354.81 Typical High $467.74 | Professional | 80 · Assistant surgeon | $213.80 | $354.81 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $309.03 Typical High $407.38 | Professional | AS · PA/NP assist | $186.21 | $309.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $2,691.53 | Facility | None | $489.78 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $2,570.40 Typical High $3,630.78 | Professional | None | $1,548.82 | $2,570.40 | $3,630.78 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,344.23 Median $3,467.37 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,467.37 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,412.54 Median $1,949.84 Typical High $3,801.89 | Professional | None | $1,412.54 | $1,949.84 | $3,801.89 |
United Setting Facility Modifier None Typical Low $2,344.23 Median $3,548.13 Typical High $6,918.31 | Facility | None | $2,344.23 | $3,548.13 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $3,801.89 | Professional | None | $1,445.44 | $1,905.46 | $3,801.89 |
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 $660.69 Median $691.83 Typical High $812.83 | Professional | 52 · Reduced service | $660.69 | $691.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $281.84 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,047.13 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,000.00 | $1,047.13 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $977.24 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $933.25 | $977.24 | $1,122.02 |
Where New Hampshire 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.