How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,122 to $12,589Professionalmedian $224 · 10th to 90th $182 to $355
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 $1,819.70 Median $6,309.57 Typical High $13,489.63 | Facility | None | $1,819.70 | $6,309.57 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $288.40 | Professional | None | $251.19 | $288.40 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $6,918.31 Typical High $13,489.63 | Facility | None | $1,819.70 | $6,918.31 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $354.81 | Professional | None | $181.97 | $213.80 | $354.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $114.82 Median $134.90 Typical High $223.87 | Professional | 62 · Two surgeons | $114.82 | $134.90 | $223.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $28.84 Median $33.88 Typical High $56.23 | Professional | 80 · Assistant surgeon | $28.84 | $33.88 | $56.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $25.70 Median $30.20 Typical High $48.98 | Professional | AS · PA/NP assist | $25.70 | $30.20 | $48.98 |
CDPHP Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $1,737.80 Typical High $3,981.07 | Facility | None | $676.08 | $1,737.80 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $467.74 | Professional | None | $204.17 | $204.17 | $467.74 |
Emblem Health Setting Facility Modifier None Typical Low $257.04 Median $331.13 Typical High $891.25 | Facility | None | $257.04 | $331.13 | $891.25 |
Emblem Health Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $457.09 | Professional | None | $223.87 | $257.04 | $457.09 |
Excellus BCBS Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $316.23 | Professional | None | $158.49 | $204.17 | $316.23 |
MVP Health Care Setting Facility Modifier None Typical Low $245.47 Median $6,456.54 Typical High $7,079.46 | Facility | None | $245.47 | $6,456.54 | $7,079.46 |
MVP Health Care Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $398.11 | Professional | None | $239.88 | $239.88 | $398.11 |
United Setting Facility Modifier None Typical Low $1,318.26 Median $3,311.31 Typical High $11,220.18 | Facility | None | $1,318.26 | $3,311.31 | $11,220.18 |
United Setting Professional Modifier None Typical Low $162.18 Median $229.09 Typical High $363.08 | Professional | None | $162.18 | $229.09 | $363.08 |
Univera Setting Facility Modifier None Typical Low $151.36 Median $223.87 Typical High $912.01 | Facility | None | $151.36 | $223.87 | $912.01 |
Univera Setting Professional Modifier None Typical Low $158.49 Median $204.17 Typical High $316.23 | Professional | None | $158.49 | $204.17 | $316.23 |
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 $123.03 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $50.12 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $213.80 Typical High $213.80 | Professional | 54 · Surgery only | $186.21 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $42.66 Typical High $42.66 | Professional | 55 · Aftercare only | $37.15 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.12 | $28.84 | $28.84 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $165.96 Typical High $229.09 | Professional | 53 · Discontinued | $125.89 | $165.96 | $229.09 |
Where New York sits
The same service costs 36.6 times more in Maine than in Montana. 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 $27,224MT $743
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.