How much rates vary
Facilitymedian $13,490 · 10th to 90th $851 to $30,903Professionalmedian $2,344 · 10th to 90th $1,698 to $3,311
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 $1,778.28 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,778.28 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,737.80 | $1,778.28 | $2,187.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $20,892.96 Typical High $32,359.37 | Facility | None | $2,691.53 | $20,892.96 | $32,359.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $2,344.23 Typical High $3,162.28 | Professional | None | $1,698.24 | $2,344.23 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,479.11 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,071.52 | $1,479.11 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $380.19 Typical High $549.54 | Professional | 80 · Assistant surgeon | $275.42 | $380.19 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $331.13 Typical High $446.68 | Professional | AS · PA/NP assist | $239.88 | $331.13 | $446.68 |
CareSource Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $2,691.53 | Facility | None | $512.86 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $3,890.45 | Professional | None | $1,778.28 | $2,344.23 | $3,890.45 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,570.40 Typical High $5,128.61 | Facility | None | $912.01 | $2,570.40 | $5,128.61 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $3,715.35 | Professional | None | $2,089.30 | $2,818.38 | $3,715.35 |
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 $1,698.24 Median $2,290.87 Typical High $3,630.78 | Professional | None | $1,698.24 | $2,290.87 | $3,630.78 |
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 $870.96 Median $891.25 Typical High $1,096.48 | Professional | 52 · Reduced service | $870.96 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $446.68 | Professional | 53 · Discontinued | $354.81 | $354.81 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $331.13 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $177.83 Typical High $218.78 | Professional | 56 · Pre-op care only | $173.78 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,548.82 |
Where Indiana 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.