How much rates vary
Facilitymedian $5,248 · 10th to 90th $398 to $19,953Professionalmedian $302 · 10th to 90th $245 to $468
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 $302.00 Median $5,495.41 Typical High $14,125.38 | Facility | None | $302.00 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $489.78 | Professional | None | $269.15 | $302.00 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $12,589.25 Typical High $23,442.29 | Facility | None | $5,248.07 | $12,589.25 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $380.19 | Professional | None | $245.47 | $295.12 | $380.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $154.88 Median $186.21 Typical High $239.88 | Professional | 62 · Two surgeons | $154.88 | $186.21 | $239.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $46.77 Typical High $60.26 | Professional | 80 · Assistant surgeon | $39.81 | $46.77 | $60.26 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $41.69 Typical High $52.48 | Professional | AS · PA/NP assist | $34.67 | $41.69 | $52.48 |
CareFirst Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $371.54 | Professional | None | $257.04 | $281.84 | $371.54 |
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 $251.19 Median $302.00 Typical High $467.74 | Professional | None | $251.19 | $302.00 | $467.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $338.84 | Professional | None | $229.09 | $275.42 | $338.84 |
Medcost Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $478.63 | Professional | None | $380.19 | $478.63 | $478.63 |
Medcost Setting Facility Modifier None Typical Low $302.00 Median $354.81 Typical High $489.78 | Facility | None | $302.00 | $354.81 | $489.78 |
Medcost Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Sentara Setting Facility Modifier None Typical Low $245.47 Median $1,202.26 Typical High $7,413.10 | Facility | None | $245.47 | $1,202.26 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $251.19 Median $346.74 Typical High $1,380.38 | Professional | None | $251.19 | $346.74 | $1,380.38 |
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 $218.78 Median $354.81 Typical High $524.81 | Professional | None | $218.78 | $354.81 | $524.81 |
5 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 $131.83 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $131.83 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $52.48 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | 54 · Surgery only | $199.53 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $39.81 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $26.30 | $30.20 | $30.20 |
Where Virginia sits
The same service costs 32.0 times more in Maine than in Montana. 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 $26,674MT $834
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.