How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $16,218Professionalmedian $1,259 · 10th to 90th $759 to $1,950
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 $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $870.96 | Professional | None | $707.95 | $758.58 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $10,000.00 Typical High $16,982.44 | Facility | None | $3,890.45 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,318.26 Typical High $1,819.70 | Professional | None | $891.25 | $1,318.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $831.76 Typical High $1,122.02 | Professional | 62 · Two surgeons | $478.63 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $208.93 Typical High $281.84 | Professional | 80 · Assistant surgeon | $120.23 | $208.93 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $181.97 Typical High $245.47 | Professional | AS · PA/NP assist | $107.15 | $181.97 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $2,691.53 | Facility | None | $489.78 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,412.54 Typical High $1,995.26 | Professional | None | $851.14 | $1,412.54 | $1,995.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $851.14 Typical High $2,884.03 | Facility | None | $776.25 | $851.14 | $2,884.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $812.83 Median $1,096.48 Typical High $2,041.74 | Professional | None | $812.83 | $1,096.48 | $2,041.74 |
United Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $2,884.03 | Facility | None | $776.25 | $933.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,071.52 Typical High $2,041.74 | Professional | None | $794.33 | $1,071.52 | $2,041.74 |
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 $354.81 Median $380.19 Typical High $436.52 | Professional | 52 · Reduced service | $354.81 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $173.78 | Professional | 53 · Discontinued | $141.25 | $151.36 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $645.65 | Professional | 54 · Surgery only | $537.03 | $562.34 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $114.82 Typical High $128.82 | Professional | 55 · Aftercare only | $107.15 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $87.10 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $602.56 |
Where New Hampshire 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.