How much rates vary
Facilitymedian $9,772 · 10th to 90th $832 to $21,878Professionalmedian $1,318 · 10th to 90th $912 to $1,862
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 $954.99 Median $3,467.37 Typical High $5,011.87 | Facility | None | $954.99 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,258.93 | Professional | None | $954.99 | $954.99 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $14,454.40 Typical High $22,908.68 | Facility | None | $1,862.09 | $14,454.40 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,380.38 Typical High $1,862.09 | Professional | None | $870.96 | $1,380.38 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $2,089.30 Typical High $2,818.38 | Professional | 50 · Both sides | $1,288.25 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $870.96 Typical High $1,174.90 | Professional | 62 · Two surgeons | $549.54 | $870.96 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $223.87 Typical High $316.23 | Professional | 80 · Assistant surgeon | $138.04 | $223.87 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $194.98 Typical High $263.03 | Professional | AS · PA/NP assist | $120.23 | $194.98 | $263.03 |
CareSource Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Facility | None | $1,047.13 | $1,047.13 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,089.30 | Professional | None | $977.24 | $1,288.25 | $2,089.30 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,187.76 Typical High $2,754.23 | Facility | None | $912.01 | $2,187.76 | $2,754.23 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,548.82 | $1,905.46 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,949.84 | Professional | None | $977.24 | $1,230.27 | $1,949.84 |
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 $478.63 Median $478.63 Typical High $630.96 | Professional | 52 · Reduced service | $478.63 | $478.63 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $251.19 | Professional | 53 · Discontinued | $190.55 | $190.55 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $724.44 Typical High $933.25 | Professional | 54 · Surgery only | $724.44 | $724.44 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | 55 · Aftercare only | $144.54 | $144.54 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $125.89 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $676.08 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $676.08 | $676.08 | $870.96 |
Where Indiana sits
The same service costs 14.5 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 $24,354MD $1,684
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.