How much rates vary
Facilitymedian $9,333 · 10th to 90th $891 to $22,909Professionalmedian $1,288 · 10th to 90th $912 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 $1,000.00 Median $5,011.87 Typical High $17,782.79 | Facility | None | $1,000.00 | $5,011.87 | $17,782.79 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,122.02 | Professional | None | $1,000.00 | $1,000.00 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $15,135.61 Typical High $24,547.09 | Facility | None | $1,862.09 | $15,135.61 | $24,547.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,348.96 Typical High $1,819.70 | Professional | None | $912.01 | $1,348.96 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $2,041.74 Typical High $2,754.23 | Professional | 50 · Both sides | $1,380.38 | $2,041.74 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $851.14 Typical High $1,148.15 | Professional | 62 · Two surgeons | $575.44 | $851.14 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $218.78 Typical High $309.03 | Professional | 80 · Assistant surgeon | $147.91 | $218.78 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $190.55 Typical High $257.04 | Professional | AS · PA/NP assist | $128.82 | $190.55 | $257.04 |
CareSource Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Facility | None | $1,096.48 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,348.96 Typical High $2,691.53 | Facility | None | $575.44 | $1,348.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,288.25 | $1,862.09 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,290.87 Typical High $2,884.03 | Facility | None | $912.01 | $2,290.87 | $2,884.03 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $2,041.74 | Professional | None | $1,096.48 | $1,348.96 | $2,041.74 |
United Setting Facility Modifier None Typical Low $302.00 Median $2,290.87 Typical High $10,232.93 | Facility | None | $302.00 | $2,290.87 | $10,232.93 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,862.09 | Professional | None | $912.01 | $1,148.15 | $1,862.09 |
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 $489.78 Median $489.78 Typical High $562.34 | Professional | 52 · Reduced service | $489.78 | $489.78 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $199.53 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $112.20 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $776.25 |
Where Indiana 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.