How much rates vary
Facilitymedian $12,589 · 10th to 90th $912 to $30,903Professionalmedian $2,344 · 10th to 90th $1,585 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 $1,659.59 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,659.59 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,659.59 | $1,659.59 | $2,089.30 |
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 $1,584.89 Median $2,398.83 Typical High $3,162.28 | Professional | None | $1,584.89 | $2,398.83 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,513.56 Typical High $2,041.74 | Professional | 62 · Two surgeons | $1,000.00 | $1,513.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $380.19 Typical High $549.54 | Professional | 80 · Assistant surgeon | $257.04 | $380.19 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $338.84 Typical High $457.09 | Professional | AS · PA/NP assist | $223.87 | $338.84 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Facility | None | $1,905.46 | $1,905.46 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,089.30 Typical High $3,715.35 | Facility | None | $562.34 | $2,089.30 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,659.59 | $2,187.76 | $3,235.94 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,398.83 Typical High $4,786.30 | Facility | None | $912.01 | $2,398.83 | $4,786.30 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,949.84 | $2,630.27 | $3,548.13 |
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 $1,659.59 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,659.59 | $2,187.76 | $3,388.44 |
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 $831.76 Median $831.76 Typical High $1,047.13 | Professional | 52 · Reduced service | $831.76 | $831.76 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $416.87 | Professional | 53 · Discontinued | $331.13 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $316.23 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $208.93 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,445.44 |
Where Indiana 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.