How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $25,704Professionalmedian $4,074 · 10th to 90th $2,630 to $6,310
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 $2,511.89 Median $4,466.84 Typical High $4,466.84 | Professional | None | $2,511.89 | $4,466.84 | $4,466.84 |
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 $2,570.40 Median $4,168.69 Typical High $5,754.40 | Professional | None | $2,570.40 | $4,168.69 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,454.71 Typical High $3,630.78 | Professional | 62 · Two surgeons | $1,584.89 | $2,454.71 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $630.96 Typical High $933.25 | Professional | 80 · Assistant surgeon | $407.38 | $630.96 | $933.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $549.54 Typical High $812.83 | Professional | AS · PA/NP assist | $354.81 | $549.54 | $812.83 |
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 $3,630.78 Median $4,073.80 Typical High $6,456.54 | Professional | None | $3,630.78 | $4,073.80 | $6,456.54 |
ConnectiCare Setting Professional Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $5,011.87 | Professional | None | $4,466.84 | $4,466.84 | $5,011.87 |
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 $2,511.89 Median $3,801.89 Typical High $8,709.64 | Professional | None | $2,511.89 | $3,801.89 | $8,709.64 |
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 $1,445.44 Median $2,238.72 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,445.44 | $2,238.72 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $891.25 Typical High $891.25 | Professional | 53 · Discontinued | $575.44 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $3,311.31 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,137.96 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $660.69 Typical High $660.69 | Professional | 55 · Aftercare only | $436.52 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $446.68 Typical High $446.68 | Professional | 56 · Pre-op care only | $288.40 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $3,090.30 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $1,995.26 | $3,090.30 | $3,090.30 |
Where Connecticut sits
The same service costs 12.3 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 $35,907WA $2,929
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.