How much rates vary
Facilitymedian $1,660 · 10th to 90th $513 to $12,589Professionalmedian $1,862 · 10th to 90th $1,288 to $3,715
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 $1,548.82 Median $6,760.83 Typical High $10,964.78 | Facility | None | $1,548.82 | $6,760.83 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $4,073.80 | Professional | None | $1,513.56 | $1,548.82 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,122.02 Median $3,388.44 Typical High $23,988.33 | Facility | None | $1,122.02 | $3,388.44 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $3,311.31 | Professional | None | $1,258.93 | $1,862.09 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $371.54 Typical High $524.81 | Professional | 80 · Assistant surgeon | $234.42 | $371.54 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $295.12 Typical High $524.81 | Professional | AS · PA/NP assist | $199.53 | $295.12 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $549.54 Typical High $2,511.89 | Facility | None | $457.09 | $549.54 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $2,630.27 Typical High $4,677.35 | Professional | None | $1,621.81 | $2,630.27 | $4,677.35 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $10,471.29 | Professional | None | $1,412.54 | $1,659.59 | $10,471.29 |
Oscar Health Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,398.83 | $2,630.27 | $2,630.27 |
United Setting Facility Modifier None Typical Low $371.54 Median $645.65 Typical High $3,981.07 | Facility | None | $371.54 | $645.65 | $3,981.07 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $2,290.87 Typical High $4,677.35 | Professional | None | $1,445.44 | $2,290.87 | $4,677.35 |
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 $758.58 Median $776.25 Typical High $851.14 | Professional | 52 · Reduced service | $758.58 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $338.84 | Professional | 53 · Discontinued | $302.00 | $309.03 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,122.02 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $229.09 Typical High $257.04 | Professional | 55 · Aftercare only | $223.87 | $229.09 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $154.88 Typical High $169.82 | Professional | 56 · Pre-op care only | $151.36 | $154.88 | $169.82 |
Where Georgia sits
The same service costs 25.6 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 $53,236MD $2,076
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.