How much rates vary
Facilitymedian $14,454 · 10th to 90th $776 to $14,791Professionalmedian $1,175 · 10th to 90th $851 to $1,738
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 Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,318.26 | Professional | None | $831.76 | $1,023.29 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $14,454.40 Typical High $15,135.61 | Facility | None | $11,481.54 | $14,454.40 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,258.93 Typical High $1,737.80 | Professional | None | $831.76 | $1,258.93 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $794.33 Typical High $1,096.48 | Professional | 62 · Two surgeons | $524.81 | $794.33 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $204.17 Typical High $275.42 | Professional | 80 · Assistant surgeon | $131.83 | $204.17 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $177.83 Typical High $239.88 | Professional | AS · PA/NP assist | $114.82 | $177.83 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $707.95 Typical High $2,290.87 | Facility | None | $151.36 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,949.84 | Professional | None | $977.24 | $1,202.26 | $1,949.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,584.89 | Professional | None | $912.01 | $1,288.25 | $1,584.89 |
Martin's Point Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,318.26 | Professional | None | $851.14 | $1,023.29 | $1,318.26 |
United Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,288.25 Typical High $1,737.80 | Professional | None | $891.25 | $1,288.25 | $1,737.80 |
2 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 $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Where Maine sits
The same service costs 10.3 times more in Maine than in Arkansas. 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 $15,629AR $1,524
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.