How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,202 to $10,233Professionalmedian $759 · 10th to 90th $603 to $1,549
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 $1,819.70 Median $6,165.95 Typical High $10,964.78 | Facility | None | $1,819.70 | $6,165.95 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,445.44 | Professional | None | $891.25 | $977.24 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $4,466.84 Typical High $10,964.78 | Facility | None | $1,548.82 | $4,466.84 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,380.38 | Professional | None | $630.96 | $741.31 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $467.74 Typical High $870.96 | Professional | 62 · Two surgeons | $398.11 | $467.74 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $120.23 Typical High $218.78 | Professional | 80 · Assistant surgeon | $102.33 | $120.23 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $104.71 Typical High $190.55 | Professional | AS · PA/NP assist | $89.13 | $104.71 | $190.55 |
CDPHP Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $2,754.23 | Facility | None | $851.14 | $1,778.28 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $3,019.95 | Professional | None | $660.69 | $870.96 | $3,019.95 |
Emblem Health Setting Facility Modifier None Typical Low $741.31 Median $891.25 Typical High $2,884.03 | Facility | None | $741.31 | $891.25 | $2,884.03 |
Emblem Health Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,412.54 | Professional | None | $741.31 | $851.14 | $1,412.54 |
Excellus BCBS Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,230.27 | Professional | None | $549.54 | $676.08 | $1,230.27 |
MVP Health Care Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $4,786.30 | Facility | None | $831.76 | $831.76 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,071.52 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $3,162.28 Typical High $9,332.54 | Facility | None | $1,230.27 | $3,162.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $562.34 Median $812.83 Typical High $2,137.96 | Professional | None | $562.34 | $812.83 | $2,137.96 |
Univera Setting Facility Modifier None Typical Low $645.65 Median $691.83 Typical High $2,884.03 | Facility | None | $645.65 | $691.83 | $2,884.03 |
Univera Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,122.02 | Professional | None | $549.54 | $676.08 | $1,122.02 |
15 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 $446.68 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $616.60 | $691.83 | $691.83 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $602.56 Typical High $1,148.15 | Professional | 54 · Surgery only | $489.78 | $602.56 | $1,148.15 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $112.20 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $112.20 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $100.00 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $100.00 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $549.54 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $446.68 | $549.54 | $1,047.13 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $512.86 Typical High $776.25 | Professional | 53 · Discontinued | $398.11 | $512.86 | $776.25 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $602.56 Typical High $1,122.02 | Professional | 54 · Surgery only | $489.78 | $602.56 | $1,122.02 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $134.90 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $134.90 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $53.70 Typical High $120.23 | Professional | 56 · Pre-op care only | $43.65 | $53.70 | $120.23 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $549.54 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $446.68 | $549.54 | $1,023.29 |
Where New York sits
The same service costs 7.8 times more in Maine than in Massachusetts. 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 $16,585MA $2,122
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.