How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $25,704Professionalmedian $3,090 · 10th to 90th $1,995 to $4,786
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 $1,995.26 Median $3,388.44 Typical High $3,388.44 | Professional | None | $1,995.26 | $3,388.44 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,585.78 Median $23,442.29 Typical High $28,183.83 | Facility | None | $7,585.78 | $23,442.29 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $3,019.95 Typical High $4,365.16 | Professional | None | $1,949.84 | $3,019.95 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,862.09 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,230.27 | $1,862.09 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $467.74 Typical High $707.95 | Professional | 80 · Assistant surgeon | $309.03 | $467.74 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $407.38 Typical High $616.60 | Professional | AS · PA/NP assist | $275.42 | $407.38 | $616.60 |
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 $2,691.53 Median $3,090.30 Typical High $5,011.87 | Professional | None | $2,691.53 | $3,090.30 | $5,011.87 |
ConnectiCare Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,981.07 | Professional | None | $3,388.44 | $3,388.44 | $3,981.07 |
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 $1,862.09 Median $2,754.23 Typical High $6,606.93 | Professional | None | $1,862.09 | $2,754.23 | $6,606.93 |
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 $1,122.02 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,122.02 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $446.68 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $1,659.59 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $331.13 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $223.87 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,344.23 | $2,344.23 |
Where Connecticut sits
The same service costs 13.8 times more in Maine than in Washington. 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 $35,114WA $2,549
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.