How much rates vary
Facilitymedian $5,623 · 10th to 90th $468 to $28,184Professionalmedian $407 · 10th to 90th $324 to $661
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 $436.52 Median $5,495.41 Typical High $14,125.38 | Facility | None | $436.52 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $588.84 | Professional | None | $398.11 | $426.58 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $17,378.01 Typical High $33,113.11 | Facility | None | $7,413.10 | $17,378.01 | $33,113.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $489.78 | Professional | None | $323.59 | $389.05 | $489.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $51.29 Median $61.66 Typical High $77.62 | Professional | 80 · Assistant surgeon | $51.29 | $61.66 | $77.62 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $53.70 Typical High $69.18 | Professional | AS · PA/NP assist | $45.71 | $53.70 | $69.18 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $512.86 | Professional | None | $363.08 | $407.38 | $512.86 |
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 $323.59 Median $457.09 Typical High $630.96 | Professional | None | $323.59 | $457.09 | $630.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $436.52 | Professional | None | $295.12 | $354.81 | $436.52 |
Medcost Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $616.60 | Facility | None | $398.11 | $398.11 | $616.60 |
Medcost Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Sentara Setting Facility Modifier None Typical Low $363.08 Median $954.99 Typical High $5,128.61 | Facility | None | $363.08 | $954.99 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $2,290.87 | Professional | None | $363.08 | $478.63 | $2,290.87 |
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 $331.13 Median $537.03 Typical High $831.76 | Professional | None | $331.13 | $537.03 | $831.76 |
5 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 $199.53 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $199.53 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $79.43 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $302.00 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $43.65 |
Where Virginia sits
The same service costs 39.3 times more in Maine than in Arkansas. 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 $37,666AR $958
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.