How much rates vary
Facilitymedian $9,772 · 10th to 90th $851 to $25,704Professionalmedian $1,660 · 10th to 90th $1,202 to $2,291
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 $1,230.27 Median $1,949.84 Typical High $5,011.87 | Facility | None | $1,230.27 | $1,949.84 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,318.26 | $1,819.70 |
Ambetter Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $16,595.87 Typical High $27,542.29 | Facility | None | $2,238.72 | $16,595.87 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,454.71 Typical High $3,311.31 | Professional | 50 · Both sides | $1,659.59 | $2,454.71 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $1,047.13 Typical High $1,412.54 | Professional | 62 · Two surgeons | $707.95 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $263.03 Typical High $371.54 | Professional | 80 · Assistant surgeon | $177.83 | $263.03 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $229.09 Typical High $309.03 | Professional | AS · PA/NP assist | $154.88 | $229.09 | $309.03 |
CareSource Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $1,230.27 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,230.27 | $1,621.81 | $2,511.89 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,548.13 | Facility | None | $912.01 | $2,290.87 | $3,548.13 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,380.38 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,995.26 | $2,454.71 |
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 $1,258.93 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,584.89 | $2,511.89 |
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 $616.60 Median $616.60 Typical High $812.83 | Professional | 52 · Reduced service | $616.60 | $616.60 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $323.59 | Professional | 53 · Discontinued | $245.47 | $245.47 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,230.27 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $162.18 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,148.15 |
Where Indiana 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.