How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $25,704Professionalmedian $2,399 · 10th to 90th $1,549 to $3,715
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 $1,445.44 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,445.44 | $2,570.40 | $2,570.40 |
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 $1,513.56 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,513.56 | $2,290.87 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $954.99 Median $1,412.54 Typical High $2,137.96 | Professional | 62 · Two surgeons | $954.99 | $1,412.54 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $354.81 Typical High $537.03 | Professional | 80 · Assistant surgeon | $239.88 | $354.81 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $309.03 Typical High $467.74 | Professional | AS · PA/NP assist | $208.93 | $309.03 | $467.74 |
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 $2,137.96 Median $2,398.83 Typical High $3,801.89 | Professional | None | $2,137.96 | $2,398.83 | $3,801.89 |
ConnectiCare Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,630.27 | $2,630.27 | $3,019.95 |
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 $1,479.11 Median $2,137.96 Typical High $5,128.61 | Professional | None | $1,479.11 | $2,137.96 | $5,128.61 |
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 $851.14 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $851.14 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $338.84 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,288.25 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $257.04 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $169.82 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,819.70 | $1,819.70 |
Where Connecticut sits
The same service costs 15.5 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 $34,449MD $2,222
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.