How much rates vary
Facilitymedian $4,266 · 10th to 90th $1,148 to $12,303Professionalmedian $1,905 · 10th to 90th $1,549 to $2,344
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 $2,041.74 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,041.74 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,041.74 Typical High $2,089.30 | Professional | None | $1,995.26 | $2,041.74 | $2,089.30 |
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 $1,621.81 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,621.81 | $1,905.46 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,202.26 Typical High $1,445.44 | Professional | 62 · Two surgeons | $1,023.29 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $309.03 Typical High $371.54 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $323.59 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $323.59 |
CareFirst Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,187.76 | Professional | None | $1,698.24 | $1,905.46 | $2,187.76 |
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 $1,548.82 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,819.70 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,548.82 Median $1,778.28 Typical High $2,884.03 | Professional | None | $1,548.82 | $1,778.28 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,737.80 | $2,238.72 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $3,235.94 | Facility | None | $1,995.26 | $2,238.72 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,584.89 | $1,621.81 | $2,187.76 |
Sentara Setting Facility Modifier None Typical Low $1,230.27 Median $2,187.76 Typical High $7,413.10 | Facility | None | $1,230.27 | $2,187.76 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,754.23 | Professional | None | $1,318.26 | $1,905.46 | $2,754.23 |
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 $1,258.93 Median $1,621.81 Typical High $2,884.03 | Professional | None | $1,258.93 | $1,621.81 | $2,884.03 |
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 $1,000.00 Median $1,000.00 Typical High $1,023.29 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $407.38 | Professional | 53 · Discontinued | $398.11 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,513.56 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,513.56 | $1,513.56 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $302.00 Typical High $309.03 | Professional | 55 · Aftercare only | $302.00 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $204.17 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,412.54 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,412.54 | $1,445.44 |
Where Virginia sits
The same service costs 7.6 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 $18,140MD $2,382
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.