How much rates vary
Facilitymedian $10,233 · 10th to 90th $891 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 $1,258.93 Median $5,011.87 Typical High $16,595.87 | Facility | None | $1,258.93 | $5,011.87 | $16,595.87 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,258.93 | $1,778.28 |
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 $2,511.89 Typical High $3,388.44 | Professional | 50 · Both sides | $1,659.59 | $2,511.89 | $3,388.44 |
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 $380.19 | Professional | 80 · Assistant surgeon | $177.83 | $263.03 | $380.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $234.42 Typical High $316.23 | Professional | AS · PA/NP assist | $154.88 | $234.42 | $316.23 |
CareSource Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $851.14 Typical High $2,691.53 | Facility | None | $575.44 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,258.93 | $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 $2,041.74 Typical High $2,454.71 | Professional | None | $1,380.38 | $2,041.74 | $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 $630.96 Median $630.96 Typical High $812.83 | Professional | 52 · Reduced service | $630.96 | $630.96 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $331.13 | Professional | 53 · Discontinued | $251.19 | $251.19 | $331.13 |
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 $125.89 Median $125.89 Typical High $162.18 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $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 13.9 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 $28,165MD $2,021
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.