How much rates vary
Facilitymedian $10,471 · 10th to 90th $1,047 to $23,442Professionalmedian $912 · 10th to 90th $741 to $1,445
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 $933.25 Median $5,495.41 Typical High $14,125.38 | Facility | None | $933.25 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $933.25 Typical High $1,778.28 | Professional | None | $870.96 | $933.25 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $12,589.25 Typical High $23,442.29 | Facility | None | $5,248.07 | $12,589.25 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,148.15 | Professional | None | $741.31 | $891.25 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,348.96 Typical High $1,698.24 | Professional | 50 · Both sides | $1,122.02 | $1,348.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $562.34 Typical High $724.44 | Professional | 62 · Two surgeons | $467.74 | $562.34 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $141.25 Typical High $181.97 | Professional | 80 · Assistant surgeon | $120.23 | $141.25 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $125.89 Typical High $158.49 | Professional | AS · PA/NP assist | $104.71 | $125.89 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,202.26 | Professional | None | $812.83 | $912.01 | $1,202.26 |
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 $758.58 Median $933.25 Typical High $1,380.38 | Professional | None | $758.58 | $933.25 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,096.48 | Professional | None | $741.31 | $891.25 | $1,096.48 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,479.11 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,479.11 | Facility | None | $891.25 | $1,122.02 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Sentara Setting Facility Modifier None Typical Low $758.58 Median $2,454.71 Typical High $18,620.87 | Facility | None | $758.58 | $2,454.71 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $7,413.10 | Professional | None | $812.83 | $1,071.52 | $7,413.10 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,182.57 Typical High $33,113.11 | Facility | None | $4,570.88 | $13,182.57 | $33,113.11 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,071.52 Typical High $1,621.81 | Professional | None | $660.69 | $1,071.52 | $1,621.81 |
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 $436.52 Median $446.68 Typical High $467.74 | Professional | 52 · Reduced service | $436.52 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $173.78 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $676.08 Typical High $707.95 | Professional | 54 · Surgery only | $660.69 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $134.90 Typical High $141.25 | Professional | 55 · Aftercare only | $131.83 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $87.10 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $630.96 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $616.60 | $630.96 | $660.69 |
Where Virginia sits
The same service costs 10.5 times more in Maine than in Massachusetts. 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 $27,425MA $2,607
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.