How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $12,882Professionalmedian $1,995 · 10th to 90th $1,288 to $3,020
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 $4,365.16 Median $5,754.40 Typical High $8,511.38 | Facility | None | $4,365.16 | $5,754.40 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,288.25 | $2,137.96 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $11,748.98 Typical High $13,803.84 | Facility | None | $3,801.89 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,949.84 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,949.84 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,174.90 Typical High $1,737.80 | Professional | 62 · Two surgeons | $776.25 | $1,174.90 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $302.00 Typical High $446.68 | Professional | 80 · Assistant surgeon | $194.98 | $302.00 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $263.03 Typical High $389.05 | Professional | AS · PA/NP assist | $169.82 | $263.03 | $389.05 |
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 $1,737.80 Median $1,949.84 Typical High $3,090.30 | Professional | None | $1,737.80 | $1,949.84 | $3,090.30 |
ConnectiCare Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,454.71 | Professional | None | $2,137.96 | $2,137.96 | $2,454.71 |
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 $1,202.26 Median $1,778.28 Typical High $4,168.69 | Professional | None | $1,202.26 | $1,778.28 | $4,168.69 |
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 $691.83 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $691.83 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $281.84 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,047.13 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $208.93 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $138.04 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $977.24 | $1,479.11 | $1,479.11 |
Where Connecticut sits
The same service costs 8.5 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 $16,489MD $1,943
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.