How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $25,704Professionalmedian $3,548 · 10th to 90th $2,344 to $5,888
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 $2,754.23 Median $3,981.07 Typical High $3,981.07 | Professional | None | $2,754.23 | $3,981.07 | $3,981.07 |
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 $2,187.76 Median $3,548.13 Typical High $5,495.41 | Professional | None | $2,187.76 | $3,548.13 | $5,495.41 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,311.31 Median $5,128.61 Typical High $8,128.31 | Professional | 50 · Both sides | $3,311.31 | $5,128.61 | $8,128.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $2,187.76 Typical High $3,388.44 | Professional | 62 · Two surgeons | $1,380.38 | $2,187.76 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $549.54 Typical High $870.96 | Professional | 80 · Assistant surgeon | $354.81 | $549.54 | $870.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $478.63 Typical High $758.58 | Professional | AS · PA/NP assist | $309.03 | $478.63 | $758.58 |
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 $3,388.44 Median $3,981.07 Typical High $5,754.40 | Professional | None | $3,388.44 | $3,981.07 | $5,754.40 |
ConnectiCare Setting Professional Modifier None Typical Low $4,168.69 Median $4,365.16 Typical High $4,365.16 | Professional | None | $4,168.69 | $4,365.16 | $4,365.16 |
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 $2,398.83 Median $3,388.44 Typical High $7,762.47 | Professional | None | $2,398.83 | $3,388.44 | $7,762.47 |
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 $1,380.38 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,380.38 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $549.54 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $2,041.74 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $407.38 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $275.42 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,818.38 | $2,818.38 |
Where Connecticut sits
The same service costs 13.0 times more in Maine than in Washington. 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 $35,671WA $2,745
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.