How much rates vary
Facilitymedian $7,943 · 10th to 90th $1,148 to $24,547Professionalmedian $2,042 · 10th to 90th $1,288 to $3,162
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 $7,585.78 Typical High $9,772.37 | Facility | None | $4,365.16 | $7,585.78 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,380.38 | $2,238.72 | $2,238.72 |
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 $1,258.93 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,995.26 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,258.93 Typical High $1,862.09 | Professional | 62 · Two surgeons | $794.33 | $1,258.93 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $323.59 Typical High $478.63 | Professional | 80 · Assistant surgeon | $204.17 | $323.59 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $281.84 Typical High $416.87 | Professional | AS · PA/NP assist | $177.83 | $281.84 | $416.87 |
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 $1,819.70 Median $2,137.96 Typical High $3,235.94 | Professional | None | $1,819.70 | $2,137.96 | $3,235.94 |
ConnectiCare Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,398.83 | Professional | None | $2,290.87 | $2,290.87 | $2,398.83 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $7,943.28 Typical High $15,488.17 | Facility | None | $1,122.02 | $7,943.28 | $15,488.17 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,905.46 Typical High $4,365.16 | Professional | None | $1,258.93 | $1,905.46 | $4,365.16 |
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 $741.31 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $741.31 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $295.12 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,096.48 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $218.78 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $147.91 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,548.82 | $1,548.82 |
Where Connecticut sits
The same service costs 13.5 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 $34,179TX $2,531
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.