How much rates vary
Facilitymedian $6,761 · 10th to 90th $759 to $16,982Professionalmedian $1,778 · 10th to 90th $1,072 to $2,512
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 $1,096.48 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $15,135.61 Typical High $23,442.29 | Facility | None | $6,918.31 | $15,135.61 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $2,511.89 | Professional | None | $1,047.13 | $1,778.28 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,630.27 Typical High $3,715.35 | Professional | 50 · Both sides | $1,513.56 | $2,630.27 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $1,122.02 Typical High $1,584.89 | Professional | 62 · Two surgeons | $645.65 | $1,122.02 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $281.84 Typical High $398.11 | Professional | 80 · Assistant surgeon | $162.18 | $281.84 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $245.47 Typical High $346.74 | Professional | AS · PA/NP assist | $141.25 | $245.47 | $346.74 |
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 $1,445.44 Median $1,659.59 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,659.59 | $2,630.27 |
ConnectiCare Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,041.74 | Professional | None | $1,819.70 | $1,819.70 | $2,041.74 |
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 $1,047.13 Median $1,380.38 Typical High $3,090.30 | Professional | None | $1,047.13 | $1,380.38 | $3,090.30 |
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 $588.84 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $588.84 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $234.42 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $870.96 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $173.78 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $117.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $812.83 | $1,122.02 | $1,122.02 |
Where Connecticut sits
The same service costs 16.4 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 $28,429MD $1,737
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.