How much rates vary
Facilitymedian $4,677 · 10th to 90th $676 to $12,882Professionalmedian $1,585 · 10th to 90th $1,023 to $2,399
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 $1,096.48 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $11,748.98 Typical High $13,803.84 | Facility | None | $3,801.89 | $11,748.98 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,548.82 Typical High $2,290.87 | Professional | None | $977.24 | $1,548.82 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $977.24 Typical High $1,412.54 | Professional | 62 · Two surgeons | $616.60 | $977.24 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $245.47 Typical High $363.08 | Professional | 80 · Assistant surgeon | $154.88 | $245.47 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $213.80 Typical High $316.23 | Professional | AS · PA/NP assist | $138.04 | $213.80 | $316.23 |
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 $1,412.54 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,584.89 | $2,454.71 |
ConnectiCare Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Professional | None | $1,737.80 | $1,737.80 | $1,949.84 |
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 $954.99 Median $1,412.54 Typical High $3,388.44 | Professional | None | $954.99 | $1,412.54 | $3,388.44 |
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 $549.54 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $549.54 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $218.78 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $831.76 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $165.96 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $109.65 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $776.25 | $1,230.27 | $1,230.27 |
Where Connecticut sits
The same service costs 9.8 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 $16,204MD $1,659
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.