How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $13,490Professionalmedian $2,630 · 10th to 90th $1,585 to $4,169
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 $1,698.24 Median $3,090.30 Typical High $4,168.69 | Professional | None | $1,698.24 | $3,090.30 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $501.19 Typical High $660.69 | Professional | 80 · Assistant surgeon | $269.15 | $501.19 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $436.52 Typical High $575.44 | Professional | AS · PA/NP assist | $234.42 | $436.52 | $575.44 |
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 $1,905.46 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,187.76 | $3,388.44 |
ConnectiCare Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,344.23 | $2,630.27 |
Health New England Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $1,412.54 Median $2,454.71 Typical High $5,495.41 | Professional | None | $1,412.54 | $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 $776.25 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $776.25 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $309.03 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,174.90 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $234.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $154.88 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,659.59 | $1,659.59 |
Where Connecticut sits
The same service costs 8.1 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 $17,891MD $2,222
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.