How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,072 to $10,233Professionalmedian $1,479 · 10th to 90th $1,202 to $2,344
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 $12,302.69 | Facility | None | $1,819.70 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,621.81 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,258.93 | $1,479.11 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $933.25 Typical High $1,445.44 | Professional | 62 · Two surgeons | $794.33 | $933.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $239.88 Typical High $363.08 | Professional | 80 · Assistant surgeon | $204.17 | $239.88 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $208.93 Typical High $316.23 | Professional | AS · PA/NP assist | $177.83 | $208.93 | $316.23 |
CDPHP Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,318.26 | $3,019.95 |
Emblem Health Setting Facility Modifier None Typical Low $1,513.56 Median $1,778.28 Typical High $5,754.40 | Facility | None | $1,513.56 | $1,778.28 | $5,754.40 |
Emblem Health Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $3,019.95 | Professional | None | $1,445.44 | $1,737.80 | $3,019.95 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,380.38 | $2,089.30 |
MVP Health Care Setting Facility Modifier None Typical Low $1,513.56 Median $5,754.40 Typical High $41,686.94 | Facility | None | $1,513.56 | $5,754.40 | $41,686.94 |
MVP Health Care Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,621.81 | $1,621.81 | $2,511.89 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,096.48 | $1,479.11 | $2,344.23 |
Univera Setting Facility Modifier None Typical Low $977.24 Median $1,445.44 Typical High $5,370.32 | Facility | None | $977.24 | $1,445.44 | $5,370.32 |
Univera Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,047.13 | $1,380.38 | $2,089.30 |
15 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 $812.83 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $812.83 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $323.59 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,230.27 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $162.18 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,288.25 | $1,288.25 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,230.27 Typical High $2,041.74 | Professional | 54 · Surgery only | $758.58 | $1,230.27 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $138.04 Typical High $223.87 | Professional | 55 · Aftercare only | $83.18 | $138.04 | $223.87 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $123.03 Typical High $204.17 | Professional | 56 · Pre-op care only | $75.86 | $123.03 | $204.17 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,096.48 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $676.08 | $1,096.48 | $1,819.70 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $812.83 Median $1,096.48 Typical High $1,479.11 | Professional | 53 · Discontinued | $812.83 | $1,096.48 | $1,479.11 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $1,230.27 Typical High $1,862.09 | Professional | 54 · Surgery only | $758.58 | $1,230.27 | $1,862.09 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $138.04 Typical High $302.00 | Professional | 55 · Aftercare only | $83.18 | $138.04 | $302.00 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $123.03 Typical High $269.15 | Professional | 56 · Pre-op care only | $75.86 | $123.03 | $269.15 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $1,096.48 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $676.08 | $1,096.48 | $1,659.59 |
Where New York 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.