How much rates vary
Facilitymedian $7,079 · 10th to 90th $912 to $16,596Professionalmedian $1,122 · 10th to 90th $794 to $1,862
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 $7,943.28 Typical High $13,489.63 | Facility | None | $4,570.88 | $7,943.28 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,148.15 | Professional | None | $741.31 | $1,122.02 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,754.40 Median $14,454.40 Typical High $19,498.45 | Facility | None | $5,754.40 | $14,454.40 | $19,498.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,737.80 | Professional | None | $776.25 | $1,174.90 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $724.44 Typical High $1,096.48 | Professional | 62 · Two surgeons | $489.78 | $724.44 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $181.97 Typical High $275.42 | Professional | 80 · Assistant surgeon | $123.03 | $181.97 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $158.49 Typical High $239.88 | Professional | AS · PA/NP assist | $107.15 | $158.49 | $239.88 |
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 $1,047.13 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,047.13 | $1,258.93 | $1,778.28 |
ConnectiCare Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,445.44 | Professional | None | $1,380.38 | $1,380.38 | $1,445.44 |
United Setting Facility Modifier None Typical Low $870.96 Median $5,495.41 Typical High $9,772.37 | Facility | None | $870.96 | $5,495.41 | $9,772.37 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,398.83 | Professional | None | $831.76 | $1,148.15 | $2,398.83 |
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 $371.54 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $371.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $151.36 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $562.34 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $112.20 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $74.13 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $524.81 | $794.33 | $794.33 |
Where Connecticut sits
The same service costs 11.6 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 $23,484TX $2,029
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.