How much rates vary
Facilitymedian $12,589 · 10th to 90th $912 to $30,903Professionalmedian $2,188 · 10th to 90th $1,622 to $3,388
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 $1,737.80 Median $3,467.37 Typical High $5,011.87 | Facility | None | $1,737.80 | $3,467.37 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,698.24 | $1,737.80 | $2,041.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $20,892.96 Typical High $32,359.37 | Facility | None | $2,691.53 | $20,892.96 | $32,359.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,570.40 Typical High $3,235.94 | Professional | None | $1,621.81 | $2,570.40 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,621.81 Typical High $2,041.74 | Professional | 62 · Two surgeons | $1,023.29 | $1,621.81 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $407.38 Typical High $549.54 | Professional | 80 · Assistant surgeon | $257.04 | $407.38 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $363.08 Typical High $457.09 | Professional | AS · PA/NP assist | $223.87 | $363.08 | $457.09 |
CareSource Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,187.76 Typical High $3,890.45 | Facility | None | $575.44 | $2,187.76 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $11,220.18 | Professional | None | $1,737.80 | $2,290.87 | $11,220.18 |
Physicians Health Plan of Northern Indiana Setting Facility Modifier None Typical Low $912.01 Median $2,454.71 Typical High $5,011.87 | Facility | None | $912.01 | $2,454.71 | $5,011.87 |
Physicians Health Plan of Northern Indiana Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $3,548.13 | Professional | None | $1,949.84 | $2,570.40 | $3,548.13 |
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 $1,513.56 Median $2,041.74 Typical High $3,311.31 | Professional | None | $1,513.56 | $2,041.74 | $3,311.31 |
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 $870.96 Typical High $1,023.29 | Professional | 52 · Reduced service | $851.14 | $870.96 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $346.74 Typical High $407.38 | Professional | 53 · Discontinued | $338.84 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $263.03 Typical High $309.03 | Professional | 55 · Aftercare only | $257.04 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $173.78 Typical High $204.17 | Professional | 56 · Pre-op care only | $169.82 | $173.78 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,202.26 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,202.26 | $1,445.44 |
Where Indiana 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.