How much rates vary
Facilitymedian $4,786 · 10th to 90th $708 to $17,378Professionalmedian $832 · 10th to 90th $661 to $1,230
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 $831.76 Median $5,495.41 Typical High $14,125.38 | Facility | None | $831.76 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $912.01 | Professional | None | $812.83 | $831.76 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,570.88 Median $10,964.78 Typical High $20,417.38 | Facility | None | $4,570.88 | $10,964.78 | $20,417.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $794.33 Typical High $1,000.00 | Professional | None | $660.69 | $794.33 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,174.90 Typical High $1,513.56 | Professional | 50 · Both sides | $977.24 | $1,174.90 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $501.19 Typical High $630.96 | Professional | 62 · Two surgeons | $416.87 | $501.19 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $125.89 Typical High $162.18 | Professional | 80 · Assistant surgeon | $104.71 | $125.89 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $109.65 Typical High $141.25 | Professional | AS · PA/NP assist | $91.20 | $109.65 | $141.25 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $794.33 Typical High $1,047.13 | Professional | None | $724.44 | $794.33 | $1,047.13 |
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 $831.76 Typical High $1,258.93 | Professional | None | $691.83 | $831.76 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $912.01 | Professional | None | $616.60 | $741.31 | $912.01 |
Medcost Setting Professional Modifier None Typical Low $870.96 Median $1,096.48 Typical High $1,096.48 | Professional | None | $870.96 | $1,096.48 | $1,096.48 |
Medcost Setting Facility Modifier None Typical Low $831.76 Median $1,023.29 Typical High $1,348.96 | Facility | None | $831.76 | $1,023.29 | $1,348.96 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Sentara Setting Facility Modifier None Typical Low $616.60 Median $1,737.80 Typical High $7,413.10 | Facility | None | $616.60 | $1,737.80 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $2,187.76 | Professional | None | $676.08 | $977.24 | $2,187.76 |
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 $602.56 Median $912.01 Typical High $1,479.11 | Professional | None | $602.56 | $912.01 | $1,479.11 |
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 $398.11 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $602.56 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $575.44 |
Where Virginia sits
The same service costs 17.6 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 $23,909MD $1,357
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.