How much rates vary
Facilitymedian $4,467 · 10th to 90th $1,047 to $15,136Professionalmedian $1,148 · 10th to 90th $912 to $1,995
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 $1,230.27 Median $5,495.41 Typical High $19,054.61 | Facility | None | $1,230.27 | $5,495.41 | $19,054.61 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $3,235.94 | Professional | None | $1,148.15 | $1,318.26 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $8,511.38 Typical High $15,135.61 | Facility | None | $2,884.03 | $8,511.38 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,380.38 | Professional | None | $912.01 | $1,096.48 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,621.81 Typical High $2,041.74 | Professional | 50 · Both sides | $1,348.96 | $1,621.81 | $2,041.74 |
CareFirst Setting Professional Modifier None Typical Low $933.25 Median $1,047.13 Typical High $1,288.25 | Professional | None | $933.25 | $1,047.13 | $1,288.25 |
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 $912.01 Median $1,318.26 Typical High $1,778.28 | Professional | None | $912.01 | $1,318.26 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,258.93 | Professional | None | $851.14 | $1,000.00 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,819.70 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,584.89 Typical High $1,862.09 | Facility | None | $1,148.15 | $1,584.89 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,513.56 | $1,513.56 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,737.80 Typical High $10,232.93 | Facility | None | $933.25 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $4,677.35 | Professional | None | $1,047.13 | $1,380.38 | $4,677.35 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $19,054.61 | Facility | None | $436.52 | $2,344.23 | $19,054.61 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,513.56 Typical High $2,238.72 | Professional | None | $912.01 | $1,513.56 | $2,238.72 |
4 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 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $912.01 | Professional | 54 · Surgery only | $851.14 | $851.14 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | 56 · Pre-op care only | $114.82 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $851.14 |
Where Virginia sits
The same service costs 9.4 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 $15,900MD $1,684
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.