How much rates vary
Facilitymedian $5,370 · 10th to 90th $1,096 to $19,498Professionalmedian $1,318 · 10th to 90th $1,047 to $2,188
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 $1,412.54 Median $7,585.78 Typical High $16,218.10 | Facility | None | $1,412.54 | $7,585.78 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $7,079.46 | Professional | None | $1,318.26 | $1,412.54 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $12,882.50 Typical High $22,908.68 | Facility | None | $5,128.61 | $12,882.50 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,258.93 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,905.46 Typical High $2,398.83 | Professional | 50 · Both sides | $1,584.89 | $1,905.46 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $223.87 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $223.87 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,258.93 | $1,584.89 |
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 $1,071.52 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,412.54 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,202.26 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,137.96 | Facility | None | $1,318.26 | $1,584.89 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,548.82 | $1,548.82 | $1,548.82 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,819.70 Typical High $6,606.93 | Facility | None | $933.25 | $1,819.70 | $6,606.93 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $5,128.61 | Professional | None | $1,174.90 | $1,548.82 | $5,128.61 |
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 $1,047.13 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,659.59 | $2,570.40 |
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 $645.65 Median $645.65 Typical High $707.95 | Professional | 52 · Reduced service | $645.65 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $263.03 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $131.83 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $131.83 | $141.25 |
Where Virginia sits
The same service costs 15.0 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 $27,402MD $1,821
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.