How much rates vary
Facilitymedian $7,586 · 10th to 90th $794 to $22,387Professionalmedian $1,778 · 10th to 90th $1,288 to $3,548
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 $4,570.88 Median $8,511.38 Typical High $16,218.10 | Facility | None | $4,570.88 | $8,511.38 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,348.96 | $2,089.30 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $17,378.01 Typical High $23,988.33 | Facility | None | $7,585.78 | $17,378.01 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $3,548.13 | Professional | None | $1,258.93 | $1,778.28 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,122.02 Typical High $2,238.72 | Professional | 62 · Two surgeons | $794.33 | $1,122.02 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $281.84 Typical High $562.34 | Professional | 80 · Assistant surgeon | $204.17 | $281.84 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $245.47 Typical High $489.78 | Professional | AS · PA/NP assist | $177.83 | $245.47 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,000.00 Typical High $27,542.29 | Facility | None | $501.19 | $1,000.00 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,344.23 | $3,388.44 |
ConnectiCare Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,398.83 | $2,630.27 | $2,630.27 |
Health New England Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
United Setting Facility Modifier None Typical Low $537.03 Median $1,258.93 Typical High $7,413.10 | Facility | None | $537.03 | $1,258.93 | $7,413.10 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,949.84 Typical High $3,548.13 | Professional | None | $1,288.25 | $1,949.84 | $3,548.13 |
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 $691.83 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $691.83 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $275.42 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,047.13 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $208.93 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $138.04 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $977.24 | $1,479.11 | $1,479.11 |
Where Connecticut sits
The same service costs 11.7 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 $24,249MD $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.