How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,122 to $38,905Professionalmedian $1,585 · 10th to 90th $1,259 to $2,512
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 $1,659.59 Median $7,244.36 Typical High $14,125.38 | Facility | None | $1,659.59 | $7,244.36 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $7,079.46 | Professional | None | $1,584.89 | $1,659.59 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $23,988.33 Typical High $44,668.36 | Facility | None | $10,232.93 | $23,988.33 | $44,668.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,513.56 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $302.00 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $208.93 Typical High $263.03 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,348.96 | $1,513.56 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $10,964.78 | Facility | None | $501.19 | $794.33 | $10,964.78 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,698.24 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,412.54 | $1,737.80 |
Medcost Setting Facility Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,570.40 | Facility | None | $1,584.89 | $1,905.46 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Sentara Setting Facility Modifier None Typical Low $1,047.13 Median $1,949.84 Typical High $6,918.31 | Facility | None | $1,047.13 | $1,949.84 | $6,918.31 |
Sentara Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $5,248.07 | Professional | None | $1,380.38 | $1,862.09 | $5,248.07 |
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 $1,258.93 Median $2,041.74 Typical High $3,090.30 | Professional | None | $1,258.93 | $2,041.74 | $3,090.30 |
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 $794.33 Median $794.33 Typical High $831.76 | Professional | 52 · Reduced service | $794.33 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $338.84 | Professional | 53 · Discontinued | $316.23 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $251.19 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $158.49 Typical High $165.96 | Professional | 56 · Pre-op care only | $158.49 | $158.49 | $165.96 |
Where Virginia 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.