How much rates vary
Facilitymedian $4,571 · 10th to 90th $851 to $11,220Professionalmedian $708 · 10th to 90th $562 to $1,479
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 $1,659.59 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,659.59 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $912.01 | Professional | None | $812.83 | $912.01 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,318.26 | Professional | None | $602.56 | $707.95 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,047.13 Typical High $1,949.84 | Professional | 50 · Both sides | $891.25 | $1,047.13 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $446.68 Typical High $831.76 | Professional | 62 · Two surgeons | $371.54 | $446.68 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $112.20 Typical High $208.93 | Professional | 80 · Assistant surgeon | $95.50 | $112.20 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $97.72 Typical High $181.97 | Professional | AS · PA/NP assist | $83.18 | $97.72 | $181.97 |
CDPHP Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
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 $616.60 Median $870.96 Typical High $2,884.03 | Professional | None | $616.60 | $870.96 | $2,884.03 |
Emblem Health Setting Facility Modifier None Typical Low $691.83 Median $891.25 Typical High $2,630.27 | Facility | None | $691.83 | $891.25 | $2,630.27 |
Emblem Health Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,288.25 | Professional | None | $724.44 | $794.33 | $1,288.25 |
Excellus BCBS Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,122.02 | Professional | None | $501.19 | $616.60 | $1,122.02 |
MVP Health Care Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $4,786.30 | Facility | None | $758.58 | $758.58 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,000.00 | $1,819.70 |
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 $524.81 Median $776.25 Typical High $2,089.30 | Professional | None | $524.81 | $776.25 | $2,089.30 |
Univera Setting Facility Modifier None Typical Low $588.84 Median $630.96 Typical High $2,691.53 | Facility | None | $588.84 | $630.96 | $2,691.53 |
Univera Setting Professional Modifier None Typical Low $501.19 Median $616.60 Typical High $1,122.02 | Professional | None | $501.19 | $616.60 | $1,122.02 |
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 $407.38 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $407.38 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $162.18 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $602.56 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $81.28 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $562.34 | $645.65 | $645.65 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $1,047.13 | Professional | 54 · Surgery only | $457.09 | $562.34 | $1,047.13 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $54.95 Typical High $104.71 | Professional | 55 · Aftercare only | $44.67 | $54.95 | $104.71 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $48.98 Typical High $93.33 | Professional | 56 · Pre-op care only | $39.81 | $48.98 | $93.33 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $512.86 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $416.87 | $512.86 | $954.99 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $501.19 Typical High $707.95 | Professional | 53 · Discontinued | $371.54 | $501.19 | $707.95 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $562.34 Typical High $1,023.29 | Professional | 54 · Surgery only | $457.09 | $562.34 | $1,023.29 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $54.95 Typical High $125.89 | Professional | 55 · Aftercare only | $44.67 | $54.95 | $125.89 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $48.98 Typical High $112.20 | Professional | 56 · Pre-op care only | $39.81 | $48.98 | $112.20 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $512.86 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $416.87 | $512.86 | $933.25 |
Where New York sits
The same service costs 17.6 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 $23,909MD $1,357
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.