How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,122 to $11,220Professionalmedian $1,549 · 10th to 90th $1,230 to $2,455
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 $5,495.41 Typical High $14,125.38 | Facility | None | $1,659.59 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,621.81 | $2,187.76 |
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 $1,230.27 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,445.44 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,819.70 Median $2,187.76 Typical High $2,754.23 | Professional | 50 · Both sides | $1,819.70 | $2,187.76 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $912.01 Typical High $1,148.15 | Professional | 62 · Two surgeons | $776.25 | $912.01 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $295.12 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $1,412.54 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,412.54 | $1,584.89 | $1,949.84 |
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 $1,230.27 Median $1,778.28 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,778.28 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,380.38 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $2,041.74 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,041.74 | $2,570.40 | $2,570.40 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $2,511.89 | Facility | None | $1,548.82 | $1,995.26 | $2,511.89 |
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 $1,023.29 Median $1,949.84 Typical High $7,413.10 | Facility | None | $1,023.29 | $1,949.84 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $5,128.61 | Professional | None | $1,348.96 | $1,862.09 | $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 $1,230.27 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,230.27 | $2,041.74 | $2,951.21 |
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 $776.25 Median $776.25 Typical High $831.76 | Professional | 52 · Reduced service | $776.25 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $331.13 | Professional | 53 · Discontinued | $309.03 | $309.03 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $251.19 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $165.96 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,174.90 |
Where Virginia sits
The same service costs 7.5 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 $16,075MD $2,147
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.