How much rates vary
Facilitymedian $4,365 · 10th to 90th $1,230 to $12,303Professionalmedian $2,344 · 10th to 90th $1,905 to $2,818
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 $2,511.89 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,511.89 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Professional | None | $2,454.71 | $2,454.71 | $2,511.89 |
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 $1,995.26 Median $2,344.23 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,344.23 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,479.11 Typical High $1,778.28 | Professional | 62 · Two surgeons | $1,258.93 | $1,479.11 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $371.54 Typical High $457.09 | Professional | 80 · Assistant surgeon | $316.23 | $371.54 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $331.13 Typical High $398.11 | Professional | AS · PA/NP assist | $275.42 | $331.13 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $2,691.53 | Professional | None | $2,089.30 | $2,344.23 | $2,691.53 |
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 $1,949.84 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,949.84 | $2,238.72 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,905.46 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,905.46 | $2,187.76 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $3,162.28 Typical High $3,162.28 | Professional | None | $2,511.89 | $3,162.28 | $3,162.28 |
Medcost Setting Facility Modifier None Typical Low $2,454.71 Median $2,691.53 Typical High $3,981.07 | Facility | None | $2,454.71 | $2,691.53 | $3,981.07 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,698.24 Typical High $2,630.27 | Professional | None | $1,621.81 | $1,698.24 | $2,630.27 |
Sentara Setting Facility Modifier None Typical Low $1,318.26 Median $2,454.71 Typical High $8,128.31 | Facility | None | $1,318.26 | $2,454.71 | $8,128.31 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,344.23 | $3,388.44 |
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 $1,584.89 Median $2,041.74 Typical High $3,548.13 | Professional | None | $1,584.89 | $2,041.74 | $3,548.13 |
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 $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | 52 · Reduced service | $1,230.27 | $1,230.27 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | 53 · Discontinued | $489.78 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $251.19 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,737.80 |
Where Virginia sits
The same service costs 7.6 times more in Maine than in Texas. 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 $18,667TX $2,469
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.