How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,148 to $12,303Professionalmedian $1,698 · 10th to 90th $1,413 to $2,089
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 $1,819.70 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,819.70 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,819.70 | Professional | None | $1,778.28 | $1,778.28 | $1,819.70 |
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 $1,445.44 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,445.44 | $1,698.24 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,071.52 Typical High $1,288.25 | Professional | 62 · Two surgeons | $912.01 | $1,071.52 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $269.15 Typical High $331.13 | Professional | 80 · Assistant surgeon | $229.09 | $269.15 | $331.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $239.88 Typical High $288.40 | Professional | AS · PA/NP assist | $204.17 | $239.88 | $288.40 |
CareFirst Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,698.24 | $1,949.84 |
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 $1,412.54 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,412.54 | $1,621.81 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,380.38 Median $1,584.89 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,584.89 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,862.09 | $2,344.23 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,778.28 Median $1,995.26 Typical High $2,884.03 | Facility | None | $1,778.28 | $1,995.26 | $2,884.03 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | None | $1,621.81 | $1,621.81 | $1,905.46 |
Sentara Setting Facility Modifier None Typical Low $1,230.27 Median $2,089.30 Typical High $7,079.46 | Facility | None | $1,230.27 | $2,089.30 | $7,079.46 |
Sentara Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,445.44 | $1,698.24 | $2,454.71 |
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 $1,148.15 Median $1,479.11 Typical High $2,570.40 | Professional | None | $1,148.15 | $1,479.11 | $2,570.40 |
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 $870.96 Median $870.96 Typical High $912.01 | Professional | 52 · Reduced service | $870.96 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | 53 · Discontinued | $354.81 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $269.15 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $181.97 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,258.93 |
Where Virginia sits
The same service costs 8.2 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 $17,891MD $2,184
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.