How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,454Professionalmedian $1,862 · 10th to 90th $1,514 to $4,074
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 $1,862.09 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,862.09 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $4,365.16 | Professional | None | $2,089.30 | $2,344.23 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $15,488.17 | Facility | None | $1,862.09 | $8,709.64 | $15,488.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $3,715.35 | Professional | None | $1,548.82 | $1,819.70 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,122.02 Typical High $2,290.87 | Professional | 62 · Two surgeons | $954.99 | $1,122.02 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $288.40 Typical High $588.84 | Professional | 80 · Assistant surgeon | $245.47 | $288.40 | $588.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $251.19 Typical High $512.86 | Professional | AS · PA/NP assist | $213.80 | $251.19 | $512.86 |
CDPHP Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,162.28 | Facility | None | $851.14 | $1,778.28 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $10,232.93 | Professional | None | $1,778.28 | $2,089.30 | $10,232.93 |
Emblem Health Setting Facility Modifier None Typical Low $2,089.30 Median $3,981.07 Typical High $7,585.78 | Facility | None | $2,089.30 | $3,981.07 | $7,585.78 |
Emblem Health Setting Professional Modifier None Typical Low $2,137.96 Median $2,398.83 Typical High $3,981.07 | Professional | None | $2,137.96 | $2,398.83 | $3,981.07 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,412.54 | $1,698.24 | $2,398.83 |
MVP Health Care Setting Facility Modifier None Typical Low $1,862.09 Median $4,786.30 Typical High $87,096.36 | Facility | None | $1,862.09 | $4,786.30 | $87,096.36 |
MVP Health Care Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $5,011.87 | Professional | None | $2,511.89 | $2,511.89 | $5,011.87 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $6,165.95 | Facility | None | $575.44 | $1,737.80 | $6,165.95 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,511.89 Typical High $6,025.60 | Professional | None | $1,584.89 | $2,511.89 | $6,025.60 |
Univera Setting Facility Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $8,317.64 | Facility | None | $1,659.59 | $1,778.28 | $8,317.64 |
Univera Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,698.24 | $2,344.23 |
15 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 $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $416.87 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $316.23 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $1,621.81 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,479.11 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,230.27 | $1,479.11 | $2,187.76 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $218.78 Typical High $331.13 | Professional | 55 · Aftercare only | $181.97 | $218.78 | $331.13 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $186.21 Typical High $275.42 | Professional | 56 · Pre-op care only | $154.88 | $186.21 | $275.42 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,288.25 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,288.25 | $1,905.46 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,288.25 Typical High $1,862.09 | Professional | 53 · Discontinued | $933.25 | $1,288.25 | $1,862.09 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,479.11 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,230.27 | $1,479.11 | $2,089.30 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $218.78 Typical High $467.74 | Professional | 55 · Aftercare only | $181.97 | $218.78 | $467.74 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $186.21 Typical High $398.11 | Professional | 56 · Pre-op care only | $154.88 | $186.21 | $398.11 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,288.25 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,288.25 | $1,819.70 |
Where New York 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.