How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,047 to $23,442Professionalmedian $1,318 · 10th to 90th $1,047 to $1,950
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 $1,348.96 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,348.96 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,288.25 Typical High $3,388.44 | Professional | None | $1,258.93 | $1,288.25 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $15,135.61 Typical High $27,542.29 | Facility | None | $6,165.95 | $15,135.61 | $27,542.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,288.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,905.46 Typical High $2,454.71 | Professional | 50 · Both sides | $1,584.89 | $1,905.46 | $2,454.71 |
CareFirst Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,621.81 | Professional | None | $1,047.13 | $1,258.93 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,122.02 | $1,318.26 | $1,949.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,412.54 | Professional | None | $954.99 | $1,148.15 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,905.46 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,288.25 | $1,548.82 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,862.09 Typical High $7,244.36 | Facility | None | $933.25 | $1,862.09 | $7,244.36 |
Sentara Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,479.11 | $2,754.23 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,513.56 Typical High $2,290.87 | Professional | None | $933.25 | $1,513.56 | $2,290.87 |
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 $630.96 Median $645.65 Typical High $676.08 | Professional | 52 · Reduced service | $630.96 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $257.04 Typical High $275.42 | Professional | 53 · Discontinued | $251.19 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $954.99 Typical High $1,023.29 | Professional | 54 · Surgery only | $933.25 | $954.99 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $190.55 Typical High $204.17 | Professional | 55 · Aftercare only | $186.21 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $128.82 Typical High $134.90 | Professional | 56 · Pre-op care only | $125.89 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $891.25 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $870.96 | $891.25 | $954.99 |
Where Virginia sits
The same service costs 18.2 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 $33,172MD $1,821
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.