How much rates vary
Facilitymedian $5,129 · 10th to 90th $955 to $13,183Professionalmedian $912 · 10th to 90th $741 to $1,122
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 $977.24 Median $5,495.41 Typical High $14,125.38 | Facility | None | $977.24 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $977.24 | Professional | None | $954.99 | $954.99 | $977.24 |
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 $776.25 Median $912.01 Typical High $1,096.48 | Professional | None | $776.25 | $912.01 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $575.44 Typical High $691.83 | Professional | 62 · Two surgeons | $489.78 | $575.44 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $147.91 Typical High $177.83 | Professional | 80 · Assistant surgeon | $123.03 | $147.91 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $128.82 Typical High $154.88 | Professional | AS · PA/NP assist | $107.15 | $128.82 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $831.76 Median $933.25 Typical High $1,071.52 | Professional | None | $831.76 | $933.25 | $1,071.52 |
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 $758.58 Median $891.25 Typical High $1,230.27 | Professional | None | $758.58 | $891.25 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,348.96 | Professional | None | $758.58 | $870.96 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,230.27 | Professional | None | $954.99 | $1,230.27 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,548.82 | Facility | None | $954.99 | $1,071.52 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $1,513.56 | Professional | None | $776.25 | $776.25 | $1,513.56 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $1,778.28 Typical High $8,709.64 | Facility | None | $676.08 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,380.38 | Professional | None | $707.95 | $912.01 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $4,897.79 Typical High $13,182.57 | Facility | None | $1,230.27 | $4,897.79 | $13,182.57 |
United Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,380.38 | Professional | None | $616.60 | $794.33 | $1,380.38 |
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 $478.63 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $478.63 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $190.55 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $724.44 | Professional | 54 · Surgery only | $707.95 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $144.54 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $676.08 |
Where Virginia sits
The same service costs 8.8 times more in Maine than in Delaware. 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 $16,945DE $1,928
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.