How much rates vary
Facilitymedian $5,129 · 10th to 90th $813 to $19,498Professionalmedian $912 · 10th to 90th $724 to $1,514
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 $977.24 Median $5,888.44 Typical High $14,125.38 | Facility | None | $977.24 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $4,897.79 | Professional | None | $912.01 | $977.24 | $4,897.79 |
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 $724.44 Median $870.96 Typical High $1,096.48 | Professional | None | $724.44 | $870.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $138.04 Typical High $177.83 | Professional | 80 · Assistant surgeon | $117.49 | $138.04 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $154.88 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,096.48 | Professional | None | $794.33 | $870.96 | $1,096.48 |
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 $724.44 Median $977.24 Typical High $1,380.38 | Professional | None | $724.44 | $977.24 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,023.29 | Professional | None | $691.83 | $812.83 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,479.11 | Facility | None | $912.01 | $1,096.48 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | None | $1,096.48 | $1,096.48 | $1,096.48 |
Sentara Setting Facility Modifier None Typical Low $794.33 Median $1,737.80 Typical High $5,128.61 | Facility | None | $794.33 | $1,737.80 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $4,073.80 | Professional | None | $812.83 | $1,071.52 | $4,073.80 |
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 $724.44 Median $1,174.90 Typical High $1,778.28 | Professional | None | $724.44 | $1,174.90 | $1,778.28 |
6 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 $457.09 Median $457.09 Typical High $489.78 | Professional | 52 · Reduced service | $457.09 | $457.09 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | 53 · Discontinued | $181.97 | $181.97 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | 54 · Surgery only | $676.08 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $676.08 |
Where Virginia sits
The same service costs 18.7 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 $26,826MD $1,433
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.