How much rates vary
Facilitymedian $4,786 · 10th to 90th $646 to $9,120Professionalmedian $741 · 10th to 90th $589 to $1,122
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 $758.58 Median $3,467.37 Typical High $5,011.87 | Facility | None | $758.58 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,047.13 | Professional | None | $758.58 | $758.58 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $5,370.32 Typical High $9,120.11 | Facility | None | $1,380.38 | $5,370.32 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $812.83 | Professional | None | $588.84 | $691.83 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $436.52 Typical High $524.81 | Professional | 62 · Two surgeons | $371.54 | $436.52 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $144.54 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $114.82 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $114.82 |
CareSource Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
CareSource Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | None | $676.08 | $676.08 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,479.11 | Professional | None | $676.08 | $812.83 | $1,479.11 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,041.74 Typical High $2,187.76 | Facility | None | $912.01 | $2,041.74 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,318.26 | Professional | None | $831.76 | $1,071.52 | $1,318.26 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,230.27 | Professional | None | $645.65 | $794.33 | $1,230.27 |
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 $380.19 Median $380.19 Typical High $524.81 | Professional | 52 · Reduced service | $380.19 | $380.19 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $151.36 Typical High $208.93 | Professional | 53 · Discontinued | $151.36 | $151.36 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $562.34 Typical High $776.25 | Professional | 54 · Surgery only | $562.34 | $562.34 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $112.20 Typical High $154.88 | Professional | 55 · Aftercare only | $112.20 | $112.20 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $524.81 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $524.81 | $524.81 | $724.44 |
Where Indiana sits
The same service costs 6.1 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 $8,436MD $1,394
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.