How much rates vary
Facilitymedian $12,303 · 10th to 90th $776 to $12,882Professionalmedian $2,570 · 10th to 90th $1,950 to $3,715
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 Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,344.23 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,589.25 Typical High $13,182.57 | Facility | None | $9,772.37 | $12,589.25 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $4,073.80 | Professional | None | $1,862.09 | $2,570.40 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,548.82 Typical High $2,344.23 | Professional | 62 · Two surgeons | $1,174.90 | $1,548.82 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $389.05 Typical High $588.84 | Professional | 80 · Assistant surgeon | $302.00 | $389.05 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $338.84 Typical High $512.86 | Professional | AS · PA/NP assist | $263.03 | $338.84 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $707.95 Typical High $2,290.87 | Facility | None | $151.36 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,818.38 | $4,265.80 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $3,715.35 | Professional | None | $1,995.26 | $2,570.40 | $3,715.35 |
Martin's Point Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,344.23 | $3,548.13 |
United Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,754.23 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,754.23 | $3,801.89 |
2 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 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,659.59 | $1,659.59 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,659.59 | $1,659.59 |
Where Maine sits
The same service costs 5.7 times more in Maine than in Washington. 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 $14,873WA $2,596
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.