How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $25,704Professionalmedian $2,951 · 10th to 90th $1,862 to $4,467
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 $1,862.09 Median $3,162.28 Typical High $3,162.28 | Professional | None | $1,862.09 | $3,162.28 | $3,162.28 |
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 $1,862.09 Median $3,019.95 Typical High $4,168.69 | Professional | None | $1,862.09 | $3,019.95 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,148.15 Median $1,737.80 Typical High $2,570.40 | Professional | 62 · Two surgeons | $1,148.15 | $1,737.80 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $446.68 Typical High $660.69 | Professional | 80 · Assistant surgeon | $288.40 | $446.68 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $389.05 Typical High $575.44 | Professional | AS · PA/NP assist | $257.04 | $389.05 | $575.44 |
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 $2,630.27 Median $2,951.21 Typical High $4,677.35 | Professional | None | $2,630.27 | $2,951.21 | $4,677.35 |
ConnectiCare Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,162.28 | $3,715.35 |
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 $1,778.28 Median $2,630.27 Typical High $6,165.95 | Professional | None | $1,778.28 | $2,630.27 | $6,165.95 |
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 $1,047.13 Median $1,584.89 Typical High $1,584.89 | Professional | 52 · Reduced service | $1,047.13 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $630.96 Typical High $630.96 | Professional | 53 · Discontinued | $416.87 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,584.89 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $316.23 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $316.23 Typical High $316.23 | Professional | 56 · Pre-op care only | $208.93 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,479.11 | $2,238.72 | $2,238.72 |
Where Connecticut sits
The same service costs 13.4 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 $34,930MD $2,604
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.