How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,202 to $14,454Professionalmedian $2,239 · 10th to 90th $1,862 to $4,169
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 $1,905.46 Median $6,309.57 Typical High $12,302.69 | Facility | None | $1,905.46 | $6,309.57 | $12,302.69 |
Aetna Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,630.27 | $2,884.03 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,862.09 Median $8,709.64 Typical High $15,488.17 | Facility | None | $1,862.09 | $8,709.64 | $15,488.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $3,311.31 | Professional | None | $1,905.46 | $2,238.72 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $2,041.74 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $354.81 Typical High $524.81 | Professional | 80 · Assistant surgeon | $302.00 | $354.81 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $316.23 Typical High $457.09 | Professional | AS · PA/NP assist | $269.15 | $316.23 | $457.09 |
CDPHP Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $3,890.45 | Facility | None | $851.14 | $1,778.28 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,238.72 Typical High $5,754.40 | Professional | None | $2,187.76 | $2,238.72 | $5,754.40 |
Emblem Health Setting Facility Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $8,912.51 | Facility | None | $2,238.72 | $2,754.23 | $8,912.51 |
Emblem Health Setting Professional Modifier None Typical Low $2,187.76 Median $2,691.53 Typical High $4,168.69 | Professional | None | $2,187.76 | $2,691.53 | $4,168.69 |
Excellus BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,737.80 | $2,041.74 | $2,951.21 |
MVP Health Care Setting Facility Modifier None Typical Low $2,290.87 Median $5,754.40 Typical High $38,018.94 | Facility | None | $2,290.87 | $5,754.40 | $38,018.94 |
MVP Health Care Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $5,495.41 | Professional | None | $2,454.71 | $2,818.38 | $5,495.41 |
United Setting Facility Modifier None Typical Low $575.44 Median $1,737.80 Typical High $6,606.93 | Facility | None | $575.44 | $1,737.80 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,818.38 Typical High $6,606.93 | Professional | None | $1,445.44 | $2,818.38 | $6,606.93 |
Univera Setting Facility Modifier None Typical Low $2,041.74 Median $2,187.76 Typical High $7,943.28 | Facility | None | $2,041.74 | $2,187.76 | $7,943.28 |
Univera Setting Professional Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,737.80 | $2,041.74 | $2,951.21 |
14 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 $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,318.26 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $524.81 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,949.84 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $389.05 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $263.03 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,995.26 | $1,995.26 |
Excellus BCBS Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,778.28 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,513.56 | $1,778.28 | $2,570.40 |
Excellus BCBS Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $269.15 Typical High $380.19 | Professional | 55 · Aftercare only | $229.09 | $269.15 | $380.19 |
Excellus BCBS Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $229.09 Typical High $323.59 | Professional | 56 · Pre-op care only | $190.55 | $229.09 | $323.59 |
Excellus BCBS Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,548.82 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,548.82 | $2,238.72 |
Univera Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,778.28 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,513.56 | $1,778.28 | $2,570.40 |
Univera Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $269.15 Typical High $741.31 | Professional | 55 · Aftercare only | $229.09 | $269.15 | $741.31 |
Univera Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $229.09 Typical High $630.96 | Professional | 56 · Pre-op care only | $190.55 | $229.09 | $630.96 |
Univera Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,548.82 Typical High $2,238.72 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,548.82 | $2,238.72 |
Where New York sits
The same service costs 12.4 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 $35,178WA $2,843
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.