How much rates vary
Facilitymedian $12,589 · 10th to 90th $912 to $30,903Professionalmedian $3,311 · 10th to 90th $2,188 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 $2,290.87 Median $3,467.37 Typical High $5,011.87 | Facility | None | $2,290.87 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,884.03 | Professional | None | $2,290.87 | $2,290.87 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $20,892.96 Typical High $32,359.37 | Facility | None | $2,754.23 | $20,892.96 | $32,359.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $3,388.44 Typical High $4,466.84 | Professional | None | $2,187.76 | $3,388.44 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $2,137.96 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,380.38 | $2,137.96 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $537.03 Typical High $758.58 | Professional | 80 · Assistant surgeon | $346.74 | $537.03 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $467.74 Typical High $630.96 | Professional | AS · PA/NP assist | $302.00 | $467.74 | $630.96 |
CareSource Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Facility | None | $2,691.53 | $2,691.53 | $2,691.53 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $2,570.40 Typical High $5,248.07 | Facility | None | $562.34 | $2,570.40 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $4,466.84 | Professional | None | $2,344.23 | $3,019.95 | $4,466.84 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $3,311.31 Typical High $6,760.83 | Facility | None | $912.01 | $3,311.31 | $6,760.83 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $2,691.53 Median $3,630.78 Typical High $4,786.30 | Professional | None | $2,691.53 | $3,630.78 | $4,786.30 |
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 $2,344.23 Median $3,019.95 Typical High $4,786.30 | Professional | None | $2,344.23 | $3,019.95 | $4,786.30 |
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 $1,148.15 Median $1,148.15 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $575.44 | Professional | 53 · Discontinued | $457.09 | $457.09 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $426.58 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $288.40 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,995.26 |
Where Indiana 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.