How much rates vary
Facilitymedian $10,471 · 10th to 90th $1,349 to $25,704Professionalmedian $4,365 · 10th to 90th $2,455 to $6,761
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 $2,754.23 Median $4,677.35 Typical High $4,677.35 | Professional | None | $2,754.23 | $4,677.35 | $4,677.35 |
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 $2,570.40 Median $4,466.84 Typical High $6,025.60 | Professional | None | $2,570.40 | $4,466.84 | $6,025.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $2,818.38 Typical High $3,715.35 | Professional | 62 · Two surgeons | $1,584.89 | $2,818.38 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $707.95 Typical High $954.99 | Professional | 80 · Assistant surgeon | $398.11 | $707.95 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $354.81 Median $630.96 Typical High $831.76 | Professional | AS · PA/NP assist | $354.81 | $630.96 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,818.38 Typical High $27,542.29 | Facility | None | $512.86 | $2,818.38 | $27,542.29 |
Cigna Setting Professional Modifier None Typical Low $3,890.45 Median $4,168.69 Typical High $7,585.78 | Professional | None | $3,890.45 | $4,168.69 | $7,585.78 |
ConnectiCare Setting Professional Modifier None Typical Low $3,388.44 Median $3,890.45 Typical High $4,677.35 | Professional | None | $3,388.44 | $3,890.45 | $4,677.35 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $9,549.93 Typical High $18,197.01 | Facility | None | $1,348.96 | $9,549.93 | $18,197.01 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $3,801.89 Typical High $8,511.38 | Professional | None | $2,137.96 | $3,801.89 | $8,511.38 |
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 $1,548.82 Median $2,344.23 Typical High $2,344.23 | Professional | 52 · Reduced service | $1,548.82 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $616.60 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $3,548.13 Typical High $3,548.13 | Professional | 54 · Surgery only | $2,344.23 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $467.74 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $309.03 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $3,311.31 Typical High $3,311.31 | Professional | 78 · Unplanned return to OR | $2,187.76 | $3,311.31 | $3,311.31 |
Where Connecticut sits
The same service costs 6.0 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 $35,671TX $5,942
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.