How much rates vary
Facilitymedian $5,754 · 10th to 90th $759 to $18,621Professionalmedian $2,089 · 10th to 90th $1,259 to $3,090
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 $6,165.95 Typical High $10,471.29 | Facility | None | $4,365.16 | $6,165.95 | $10,471.29 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $2,398.83 Typical High $2,884.03 | Professional | None | $1,318.26 | $2,398.83 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,760.83 Median $15,848.93 Typical High $22,908.68 | Facility | None | $6,760.83 | $15,848.93 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,230.27 | $1,995.26 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $3,019.95 Typical High $4,466.84 | Professional | 50 · Both sides | $1,778.28 | $3,019.95 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $1,258.93 Typical High $1,862.09 | Professional | 62 · Two surgeons | $758.58 | $1,258.93 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $316.23 Typical High $478.63 | Professional | 80 · Assistant surgeon | $190.55 | $316.23 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $281.84 Typical High $416.87 | Professional | AS · PA/NP assist | $165.96 | $281.84 | $416.87 |
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 $1,819.70 Median $2,089.30 Typical High $3,388.44 | Professional | None | $1,819.70 | $2,089.30 | $3,388.44 |
ConnectiCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,344.23 | Professional | None | $2,187.76 | $2,187.76 | $2,344.23 |
Health New England Setting Professional Modifier None Typical Low $144.54 Median $302.00 Typical High $3,162.28 | Professional | None | $144.54 | $302.00 | $3,162.28 |
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 $1,288.25 Median $1,778.28 Typical High $4,265.80 | Professional | None | $1,288.25 | $1,778.28 | $4,265.80 |
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 $758.58 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $758.58 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $302.00 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,148.15 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $229.09 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $151.36 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,698.24 | $1,698.24 |
Where Connecticut sits
The same service costs 14.0 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 $28,122MD $2,008
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.