How much rates vary
Facilitymedian $7,079 · 10th to 90th $813 to $15,136Professionalmedian $1,585 · 10th to 90th $1,096 to $2,188
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 $1,513.56 | Professional | None | $1,174.90 | $1,174.90 | $1,513.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $10,000.00 Typical High $16,982.44 | Facility | None | $1,659.59 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,621.81 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $1,023.29 Typical High $1,380.38 | Professional | 62 · Two surgeons | $660.69 | $1,023.29 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $257.04 Typical High $363.08 | Professional | 80 · Assistant surgeon | $169.82 | $257.04 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $223.87 Typical High $302.00 | Professional | AS · PA/NP assist | $147.91 | $223.87 | $302.00 |
CareSource Setting Facility Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Facility | None | $1,288.25 | $1,288.25 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,445.44 Typical High $2,691.53 | Facility | None | $562.34 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,122.02 | $1,548.82 | $2,238.72 |
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 $1,905.46 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,905.46 | $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 $1,174.90 Median $1,479.11 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,479.11 | $2,344.23 |
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 $758.58 | Professional | 52 · Reduced service | $588.84 | $588.84 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $302.00 | Professional | 53 · Discontinued | $234.42 | $234.42 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $870.96 Typical High $1,148.15 | Professional | 54 · Surgery only | $870.96 | $870.96 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $173.78 Typical High $229.09 | Professional | 55 · Aftercare only | $173.78 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $151.36 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $812.83 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $812.83 | $812.83 | $1,071.52 |
Where Indiana sits
The same service costs 9.0 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 $17,266MD $1,911
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.