How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,175 to $12,882Professionalmedian $1,778 · 10th to 90th $1,479 to $2,188
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 $1,905.46 Median $5,623.41 Typical High $18,620.87 | Facility | None | $1,905.46 | $5,623.41 | $18,620.87 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,905.46 | Professional | None | $1,819.70 | $1,819.70 | $1,905.46 |
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 $1,548.82 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,548.82 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,148.15 Typical High $1,380.38 | Professional | 62 · Two surgeons | $977.24 | $1,148.15 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $288.40 Typical High $346.74 | Professional | 80 · Assistant surgeon | $245.47 | $288.40 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $251.19 Typical High $309.03 | Professional | AS · PA/NP assist | $218.78 | $251.19 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,089.30 | Professional | None | $1,621.81 | $1,819.70 | $2,089.30 |
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 $1,479.11 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,479.11 | $1,737.80 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,698.24 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $2,454.71 | Professional | None | $1,905.46 | $2,454.71 | $2,454.71 |
Medcost Setting Facility Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $3,019.95 | Facility | None | $1,819.70 | $2,089.30 | $3,019.95 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,584.89 | $1,698.24 | $2,691.53 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,089.30 Typical High $7,413.10 | Facility | None | $1,288.25 | $2,089.30 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $2,630.27 | Professional | None | $1,348.96 | $1,778.28 | $2,630.27 |
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 $1,202.26 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,202.26 | $1,548.82 | $2,691.53 |
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 $912.01 Median $912.01 Typical High $954.99 | Professional | 52 · Reduced service | $912.01 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $389.05 | Professional | 53 · Discontinued | $363.08 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $288.40 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,348.96 |
Where Virginia sits
The same service costs 7.8 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 $17,987MD $2,300
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.