How much rates vary
Facilitymedian $4,786 · 10th to 90th $676 to $25,704Professionalmedian $3,090 · 10th to 90th $1,950 to $5,012
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 $1,995.26 Median $3,235.94 Typical High $3,235.94 | Professional | None | $1,995.26 | $3,235.94 | $3,235.94 |
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 $2,290.87 Median $3,162.28 Typical High $4,570.88 | Professional | None | $2,290.87 | $3,162.28 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,995.26 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,445.44 | $1,995.26 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $501.19 Typical High $724.44 | Professional | 80 · Assistant surgeon | $363.08 | $501.19 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $446.68 Typical High $630.96 | Professional | AS · PA/NP assist | $316.23 | $446.68 | $630.96 |
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 $2,754.23 Median $2,951.21 Typical High $5,248.07 | Professional | None | $2,754.23 | $2,951.21 | $5,248.07 |
ConnectiCare Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $3,235.94 | Professional | None | $2,187.76 | $2,691.53 | $3,235.94 |
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 $1,513.56 Median $2,691.53 Typical High $5,888.44 | Professional | None | $1,513.56 | $2,691.53 | $5,888.44 |
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 $1,096.48 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,096.48 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $436.52 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $1,621.81 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $323.59 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $218.78 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $2,238.72 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,513.56 | $2,238.72 | $2,238.72 |
Where Connecticut sits
The same service costs 14.0 times more in Maine than in Texas. 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 $34,704TX $2,477
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.