How much rates vary
Facilitymedian $8,511 · 10th to 90th $1,622 to $20,893Professionalmedian $1,514 · 10th to 90th $1,259 to $1,905
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 $1,621.81 Median $6,165.95 Typical High $14,125.38 | Facility | None | $1,621.81 | $6,165.95 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,548.82 | $1,621.81 | $2,398.83 |
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 $1,288.25 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,548.82 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $954.99 Typical High $1,148.15 | Professional | 62 · Two surgeons | $812.83 | $954.99 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $245.47 Typical High $295.12 | Professional | 80 · Assistant surgeon | $208.93 | $245.47 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $257.04 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $1,737.80 | Professional | None | $1,348.96 | $1,513.56 | $1,737.80 |
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 $1,258.93 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,258.93 | $1,445.44 | $2,041.74 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,230.27 Median $1,412.54 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,412.54 | $2,238.72 |
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 $1,548.82 Median $1,778.28 Typical High $2,570.40 | Facility | None | $1,548.82 | $1,778.28 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,548.82 | $2,511.89 |
Sentara Setting Facility Modifier None Typical Low $1,096.48 Median $2,570.40 Typical High $10,232.93 | Facility | None | $1,096.48 | $2,570.40 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,318.26 | $1,513.56 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,318.26 | $2,290.87 |
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 $776.25 Median $776.25 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $316.23 Typical High $323.59 | Professional | 53 · Discontinued | $316.23 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $239.88 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,122.02 |
Where Virginia sits
The same service costs 8.5 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 $28,081DE $3,299
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.