How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $13,490Professionalmedian $2,570 · 10th to 90th $1,479 to $4,074
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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,513.56 | $2,344.23 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,073.80 Median $12,022.64 Typical High $14,125.38 | Facility | None | $4,073.80 | $12,022.64 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $3,019.95 Typical High $4,073.80 | Professional | None | $1,513.56 | $3,019.95 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,905.46 Typical High $2,570.40 | Professional | 62 · Two surgeons | $954.99 | $1,905.46 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $478.63 Typical High $645.65 | Professional | 80 · Assistant surgeon | $239.88 | $478.63 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $426.58 Typical High $562.34 | Professional | AS · PA/NP assist | $208.93 | $426.58 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,137.96 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,137.96 | $3,388.44 |
ConnectiCare Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,290.87 | $2,570.40 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $2,454.71 Typical High $5,495.41 | Professional | None | $1,380.38 | $2,454.71 | $5,495.41 |
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 $758.58 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $758.58 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $302.00 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,148.15 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $229.09 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $151.36 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,621.81 | $1,621.81 |
Where Connecticut sits
The same service costs 8.2 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 $17,891MD $2,184
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.