How much rates vary
Facilitymedian $4,571 · 10th to 90th $1,148 to $11,220Professionalmedian $1,349 · 10th to 90th $1,072 to $2,754
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 $1,584.89 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,584.89 | $1,698.24 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $6,456.54 Typical High $12,589.25 | Facility | None | $1,698.24 | $6,456.54 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $2,454.71 | Professional | None | $1,122.02 | $1,318.26 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $831.76 Typical High $1,548.82 | Professional | 62 · Two surgeons | $707.95 | $831.76 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $213.80 Typical High $389.05 | Professional | 80 · Assistant surgeon | $181.97 | $213.80 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $186.21 Typical High $346.74 | Professional | AS · PA/NP assist | $158.49 | $186.21 | $346.74 |
CDPHP Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $1,202.26 Median $1,479.11 Typical High $5,370.32 | Professional | None | $1,202.26 | $1,479.11 | $5,370.32 |
Emblem Health Setting Facility Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $4,786.30 | Facility | None | $1,445.44 | $2,290.87 | $4,786.30 |
Emblem Health Setting Professional Modifier None Typical Low $1,412.54 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,412.54 | $1,548.82 | $2,511.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,187.76 | Professional | None | $977.24 | $1,202.26 | $2,187.76 |
MVP Health Care Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $4,786.30 | Facility | None | $1,513.56 | $1,513.56 | $4,786.30 |
MVP Health Care Setting Professional Modifier None Typical Low $1,949.84 Median $1,995.26 Typical High $3,388.44 | Professional | None | $1,949.84 | $1,995.26 | $3,388.44 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,778.28 Typical High $6,309.57 | Facility | None | $575.44 | $1,778.28 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,445.44 Typical High $3,801.89 | Professional | None | $1,000.00 | $1,445.44 | $3,801.89 |
Univera Setting Facility Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $5,248.07 | Facility | None | $1,148.15 | $1,230.27 | $5,248.07 |
Univera Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,041.74 | Professional | None | $977.24 | $1,202.26 | $2,041.74 |
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 $794.33 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $794.33 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $316.23 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,174.90 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $239.88 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $158.49 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,202.26 | $1,202.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,071.52 Typical High $2,041.74 | Professional | 54 · Surgery only | $891.25 | $1,071.52 | $2,041.74 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $107.15 Typical High $204.17 | Professional | 55 · Aftercare only | $87.10 | $107.15 | $204.17 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $95.50 Typical High $181.97 | Professional | 56 · Pre-op care only | $77.62 | $95.50 | $181.97 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $977.24 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $812.83 | $977.24 | $1,862.09 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $933.25 Typical High $1,380.38 | Professional | 53 · Discontinued | $707.95 | $933.25 | $1,380.38 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,071.52 Typical High $1,995.26 | Professional | 54 · Surgery only | $891.25 | $1,071.52 | $1,995.26 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $107.15 Typical High $245.47 | Professional | 55 · Aftercare only | $87.10 | $107.15 | $245.47 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $95.50 Typical High $218.78 | Professional | 56 · Pre-op care only | $77.62 | $95.50 | $218.78 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $977.24 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $812.83 | $977.24 | $1,819.70 |
Where New York sits
The same service costs 12.0 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 $24,859MD $2,076
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.