How much rates vary
Facilitymedian $9,772 · 10th to 90th $912 to $25,704Professionalmedian $1,413 · 10th to 90th $1,047 to $1,995
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 $1,122.02 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,122.02 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,513.56 | $1,513.56 |
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 $1,000.00 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,000.00 | $1,412.54 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,137.96 Typical High $2,884.03 | Professional | 50 · Both sides | $1,513.56 | $2,137.96 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $891.25 Typical High $1,230.27 | Professional | 62 · Two surgeons | $630.96 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $223.87 Typical High $323.59 | Professional | 80 · Assistant surgeon | $162.18 | $223.87 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $199.53 Typical High $269.15 | Professional | AS · PA/NP assist | $141.25 | $199.53 | $269.15 |
CareSource Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $1,412.54 Typical High $2,691.53 | Facility | None | $630.96 | $1,412.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,071.52 | $1,479.11 | $2,187.76 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,235.94 | Facility | None | $912.01 | $2,290.87 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,258.93 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,258.93 | $1,819.70 | $2,238.72 |
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 $1,122.02 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,412.54 | $2,238.72 |
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 $562.34 Median $562.34 Typical High $741.31 | Professional | 52 · Reduced service | $562.34 | $562.34 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $295.12 | Professional | 53 · Discontinued | $223.87 | $223.87 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Professional | 54 · Surgery only | $831.76 | $831.76 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $218.78 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $147.91 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $1,023.29 |
Where Indiana sits
The same service costs 14.8 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 $28,001MD $1,894
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.