How much rates vary
Facilitymedian $9,550 · 10th to 90th $1,202 to $21,380Professionalmedian $1,413 · 10th to 90th $977 to $1,995
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 $1,148.15 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,148.15 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,148.15 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $14,125.38 Typical High $22,908.68 | Facility | None | $1,862.09 | $14,125.38 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,479.11 Typical High $1,949.84 | Professional | None | $933.25 | $1,479.11 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $933.25 Typical High $1,258.93 | Professional | 62 · Two surgeons | $588.84 | $933.25 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $239.88 Typical High $331.13 | Professional | 80 · Assistant surgeon | $151.36 | $239.88 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $208.93 Typical High $275.42 | Professional | AS · PA/NP assist | $131.83 | $208.93 | $275.42 |
CareSource Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Facility | None | $1,174.90 | $1,174.90 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,412.54 | $2,041.74 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $3,019.95 | Facility | None | $912.01 | $2,290.87 | $3,019.95 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,412.54 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $4,168.69 Typical High $9,120.11 | Facility | None | $1,096.48 | $4,168.69 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,348.96 | $2,089.30 |
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 $512.86 Median $562.34 Typical High $676.08 | Professional | 52 · Reduced service | $512.86 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $229.09 Typical High $269.15 | Professional | 53 · Discontinued | $208.93 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $851.14 Typical High $1,023.29 | Professional | 54 · Surgery only | $776.25 | $851.14 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $169.82 Typical High $204.17 | Professional | 55 · Aftercare only | $154.88 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $114.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $104.71 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $794.33 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $724.44 | $794.33 | $954.99 |
Where Indiana sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.