How much rates vary
Facilitymedian $9,333 · 10th to 90th $891 to $21,878Professionalmedian $1,660 · 10th to 90th $1,122 to $2,399
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 $1,174.90 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,174.90 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,174.90 | $1,548.82 |
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 $1,071.52 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,071.52 | $1,819.70 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,691.53 Typical High $3,630.78 | Professional | 50 · Both sides | $1,584.89 | $2,691.53 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $1,148.15 Typical High $1,548.82 | Professional | 62 · Two surgeons | $676.08 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $288.40 Typical High $407.38 | Professional | 80 · Assistant surgeon | $169.82 | $288.40 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $251.19 Typical High $338.84 | Professional | AS · PA/NP assist | $147.91 | $251.19 | $338.84 |
CareSource Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Facility | None | $1,318.26 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $2,691.53 | Facility | None | $562.34 | $1,513.56 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,398.83 | Professional | None | $1,174.90 | $1,548.82 | $2,398.83 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,388.44 | Facility | None | $912.01 | $2,290.87 | $3,388.44 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,949.84 | $2,344.23 |
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 $1,202.26 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,202.26 | $1,513.56 | $2,454.71 |
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 $588.84 Median $588.84 Typical High $776.25 | Professional | 52 · Reduced service | $588.84 | $588.84 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $309.03 | Professional | 53 · Discontinued | $239.88 | $239.88 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,174.90 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $234.42 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,096.48 |
Where Indiana sits
The same service costs 12.5 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 $24,646MD $1,975
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.