How much rates vary
Facilitymedian $4,169 · 10th to 90th $851 to $12,303Professionalmedian $1,230 · 10th to 90th $1,023 to $1,549
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 $1,318.26 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,318.26 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,318.26 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $7,413.10 Typical High $14,125.38 | Facility | None | $3,162.28 | $7,413.10 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,258.93 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $954.99 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $199.53 Typical High $239.88 | Professional | 80 · Assistant surgeon | $173.78 | $199.53 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $173.78 Typical High $213.80 | Professional | AS · PA/NP assist | $151.36 | $173.78 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,479.11 | Professional | None | $1,148.15 | $1,288.25 | $1,479.11 |
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 $1,023.29 Median $1,202.26 Typical High $1,659.59 | Professional | None | $1,023.29 | $1,202.26 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,174.90 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,479.11 | $1,548.82 |
Medcost Setting Facility Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $2,137.96 | Facility | None | $1,318.26 | $1,445.44 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,412.54 | Professional | None | $1,000.00 | $1,071.52 | $1,412.54 |
Sentara Setting Facility Modifier None Typical Low $812.83 Median $1,862.09 Typical High $6,165.95 | Facility | None | $812.83 | $1,862.09 | $6,165.95 |
Sentara Setting Professional Modifier None Typical Low $776.25 Median $1,230.27 Typical High $1,862.09 | Professional | None | $776.25 | $1,230.27 | $1,862.09 |
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 $831.76 Median $1,047.13 Typical High $1,862.09 | Professional | None | $831.76 | $1,047.13 | $1,862.09 |
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 $588.84 Median $588.84 Typical High $645.65 | Professional | 52 · Reduced service | $588.84 | $588.84 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $891.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $194.98 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $117.49 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $912.01 |
Where Virginia sits
The same service costs 12.2 times more in Maine than in Florida. 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 $17,328FL $1,425
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.