How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,096 to $11,220Professionalmedian $1,479 · 10th to 90th $1,175 to $2,239
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 $5,495.41 Typical High $14,125.38 | Facility | None | $1,548.82 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,513.56 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $7,413.10 Typical High $12,589.25 | Facility | None | $2,818.38 | $7,413.10 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,380.38 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,737.80 Median $2,089.30 Typical High $2,630.27 | Professional | 50 · Both sides | $1,737.80 | $2,089.30 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $870.96 Typical High $1,096.48 | Professional | 62 · Two surgeons | $741.31 | $870.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $281.84 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $194.98 Typical High $245.47 | Professional | AS · PA/NP assist | $162.18 | $194.98 | $245.47 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,230.27 | $1,348.96 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,495.41 | Facility | None | $501.19 | $1,174.90 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,584.89 Typical High $2,187.76 | Professional | None | $1,174.90 | $1,584.89 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
Medcost Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,659.59 | $2,089.30 | $2,089.30 |
Medcost Setting Facility Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $2,344.23 | Facility | None | $1,412.54 | $1,905.46 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Sentara Setting Facility Modifier None Typical Low $977.24 Median $1,862.09 Typical High $7,413.10 | Facility | None | $977.24 | $1,862.09 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $5,128.61 | Professional | None | $1,174.90 | $1,698.24 | $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 $1,148.15 Median $1,778.28 Typical High $2,754.23 | Professional | None | $1,148.15 | $1,778.28 | $2,754.23 |
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 $707.95 Median $707.95 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $288.40 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,096.48 |
Where Virginia sits
The same service costs 8.1 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 $15,945MD $1,975
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.