How much rates vary
Facilitymedian $4,169 · 10th to 90th $1,122 to $12,303Professionalmedian $1,738 · 10th to 90th $1,445 to $2,138
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 $1,862.09 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,862.09 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,862.09 Typical High $2,290.87 | Professional | None | $1,819.70 | $1,862.09 | $2,290.87 |
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 $1,479.11 Median $1,737.80 Typical High $2,089.30 | Professional | None | $1,479.11 | $1,737.80 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $338.84 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $245.47 Typical High $295.12 | Professional | AS · PA/NP assist | $204.17 | $245.47 | $295.12 |
CareFirst Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,737.80 | $1,995.26 |
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 $1,659.59 Typical High $2,344.23 | Professional | None | $1,412.54 | $1,659.59 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,621.81 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $2,344.23 Typical High $2,344.23 | Professional | None | $1,819.70 | $2,344.23 | $2,344.23 |
Medcost Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,951.21 | Facility | None | $1,819.70 | $2,041.74 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,949.84 | Professional | None | $831.76 | $1,096.48 | $1,949.84 |
Sentara Setting Facility Modifier None Typical Low $1,096.48 Median $2,089.30 Typical High $7,244.36 | Facility | None | $1,096.48 | $2,089.30 | $7,244.36 |
Sentara Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,737.80 | $2,511.89 |
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 $1,174.90 Median $1,513.56 Typical High $2,630.27 | Professional | None | $1,174.90 | $1,513.56 | $2,630.27 |
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 $891.25 Median $891.25 Typical High $933.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $371.54 | Professional | 53 · Discontinued | $363.08 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $275.42 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $186.21 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,288.25 |
Where Virginia sits
The same service costs 8.1 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 $2,222
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.