How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $25,704Professionalmedian $3,311 · 10th to 90th $2,089 to $5,129
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 $2,344.23 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,344.23 | $3,548.13 | $3,548.13 |
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 $2,089.30 Median $3,162.28 Typical High $4,677.35 | Professional | None | $2,089.30 | $3,162.28 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,288.25 Median $1,995.26 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,288.25 | $1,995.26 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $501.19 Typical High $741.31 | Professional | 80 · Assistant surgeon | $331.13 | $501.19 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $288.40 Median $436.52 Typical High $645.65 | Professional | AS · PA/NP assist | $288.40 | $436.52 | $645.65 |
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 $2,951.21 Median $3,311.31 Typical High $5,248.07 | Professional | None | $2,951.21 | $3,311.31 | $5,248.07 |
ConnectiCare Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,168.69 | Professional | None | $3,630.78 | $3,630.78 | $4,168.69 |
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 $1,995.26 Median $2,951.21 Typical High $7,079.46 | Professional | None | $1,995.26 | $2,951.21 | $7,079.46 |
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 $1,174.90 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,174.90 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $467.74 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,630.27 Typical High $2,630.27 | Professional | 54 · Surgery only | $1,778.28 | $2,630.27 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $354.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $234.42 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,454.71 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,454.71 | $2,454.71 |
Where Connecticut sits
The same service costs 14.0 times more in Maine than in Texas. 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 $35,243TX $2,509
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.