How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $13,490Professionalmedian $1,288 · 10th to 90th $724 to $1,995
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 $758.58 Median $1,096.48 Typical High $1,096.48 | Professional | None | $758.58 | $1,096.48 | $1,096.48 |
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 $741.31 Median $1,548.82 Typical High $2,041.74 | Professional | None | $741.31 | $1,548.82 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $954.99 Typical High $1,288.25 | Professional | 62 · Two surgeons | $467.74 | $954.99 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $245.47 Typical High $331.13 | Professional | 80 · Assistant surgeon | $117.49 | $245.47 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $213.80 Typical High $288.40 | Professional | AS · PA/NP assist | $102.33 | $213.80 | $288.40 |
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 $933.25 Median $1,023.29 Typical High $1,659.59 | Professional | None | $933.25 | $1,023.29 | $1,659.59 |
ConnectiCare Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,288.25 | Professional | None | $933.25 | $1,174.90 | $1,288.25 |
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 $691.83 Median $1,202.26 Typical High $2,691.53 | Professional | None | $691.83 | $1,202.26 | $2,691.53 |
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 $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $380.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $151.36 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $562.34 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $112.20 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $75.86 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $524.81 | $776.25 | $776.25 |
Where Connecticut sits
The same service costs 12.3 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 $16,849MD $1,375
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.