How much rates vary
Facilitymedian $4,074 · 10th to 90th $741 to $12,303Professionalmedian $832 · 10th to 90th $692 to $1,023
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 $891.25 Median $5,495.41 Typical High $14,125.38 | Facility | None | $891.25 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $870.96 Typical High $891.25 | Professional | None | $831.76 | $870.96 | $891.25 |
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 $724.44 Median $851.14 Typical High $1,023.29 | Professional | None | $724.44 | $851.14 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $537.03 Typical High $645.65 | Professional | 62 · Two surgeons | $457.09 | $537.03 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $162.18 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $120.23 Typical High $141.25 | Professional | AS · PA/NP assist | $102.33 | $120.23 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $851.14 Typical High $977.24 | Professional | None | $758.58 | $851.14 | $977.24 |
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 $691.83 Median $812.83 Typical High $1,122.02 | Professional | None | $691.83 | $812.83 | $1,122.02 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,202.26 | Professional | None | $691.83 | $812.83 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | None | $933.25 | $1,174.90 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $977.24 Typical High $1,348.96 | Facility | None | $831.76 | $977.24 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $1,000.00 | Professional | None | $794.33 | $912.01 | $1,000.00 |
Sentara Setting Facility Modifier None Typical Low $660.69 Median $1,737.80 Typical High $6,165.95 | Facility | None | $660.69 | $1,737.80 | $6,165.95 |
Sentara Setting Professional Modifier None Typical Low $741.31 Median $831.76 Typical High $1,230.27 | Professional | None | $741.31 | $831.76 | $1,230.27 |
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 $575.44 Median $741.31 Typical High $1,230.27 | Professional | None | $575.44 | $741.31 | $1,230.27 |
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 $416.87 Median $416.87 Typical High $446.68 | Professional | 52 · Reduced service | $416.87 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $165.96 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $630.96 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $630.96 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $89.13 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $588.84 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $588.84 | $588.84 | $630.96 |
Where Virginia sits
The same service costs 12.3 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 $16,849MD $1,375
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.