How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,000 to $10,000Professionalmedian $1,380 · 10th to 90th $1,148 to $1,698
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 $1,479.11 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,479.11 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,479.11 | Professional | None | $1,445.44 | $1,445.44 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $6,456.54 Typical High $10,964.78 | Facility | None | $2,454.71 | $6,456.54 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,380.38 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $870.96 Typical High $1,071.52 | Professional | 62 · Two surgeons | $741.31 | $870.96 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $269.15 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $234.42 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,380.38 | $1,584.89 |
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 $1,122.02 Median $1,348.96 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,348.96 | $1,819.70 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,348.96 | $1,905.46 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,584.89 Typical High $2,344.23 | Facility | None | $1,445.44 | $1,584.89 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,778.28 | Professional | None | $1,202.26 | $1,202.26 | $1,778.28 |
Sentara Setting Facility Modifier None Typical Low $1,000.00 Median $1,862.09 Typical High $5,754.40 | Facility | None | $1,000.00 | $1,862.09 | $5,754.40 |
Sentara Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,318.26 | $1,995.26 |
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 $912.01 Median $1,202.26 Typical High $1,995.26 | Professional | None | $912.01 | $1,202.26 | $1,995.26 |
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 $707.95 Median $707.95 Typical High $741.31 | Professional | 52 · Reduced service | $707.95 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $295.12 | Professional | 53 · Discontinued | $288.40 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,071.52 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $213.80 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,000.00 | $1,047.13 |
Where Virginia sits
The same service costs 7.3 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 $13,962MD $1,911
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.