How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,148 to $38,905Professionalmedian $1,738 · 10th to 90th $1,380 to $2,884
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 $1,862.09 Median $7,244.36 Typical High $14,125.38 | Facility | None | $1,862.09 | $7,244.36 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,737.80 Median $1,862.09 Typical High $4,365.16 | Professional | None | $1,737.80 | $1,862.09 | $4,365.16 |
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 $1,380.38 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,380.38 | $1,659.59 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $338.84 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $234.42 Typical High $295.12 | Professional | AS · PA/NP assist | $194.98 | $234.42 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,659.59 Typical High $2,089.30 | Professional | None | $1,513.56 | $1,659.59 | $2,089.30 |
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 $1,380.38 Median $1,905.46 Typical High $2,630.27 | Professional | None | $1,380.38 | $1,905.46 | $2,630.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,548.82 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $1,737.80 Median $2,089.30 Typical High $2,818.38 | Facility | None | $1,737.80 | $2,089.30 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
Sentara Setting Facility Modifier None Typical Low $1,174.90 Median $1,995.26 Typical High $6,918.31 | Facility | None | $1,174.90 | $1,995.26 | $6,918.31 |
Sentara Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $5,495.41 | Professional | None | $1,513.56 | $2,041.74 | $5,495.41 |
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 $1,380.38 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,380.38 | $2,238.72 | $3,388.44 |
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 $870.96 Median $870.96 Typical High $933.25 | Professional | 52 · Reduced service | $870.96 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $346.74 Typical High $371.54 | Professional | 53 · Discontinued | $346.74 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,288.25 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,288.25 | $1,288.25 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $257.04 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $173.78 Typical High $186.21 | Professional | 56 · Pre-op care only | $173.78 | $173.78 | $186.21 |
Where Virginia sits
The same service costs 24.1 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 $53,525MD $2,222
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.