How much rates vary
Facilitymedian $4,786 · 10th to 90th $759 to $17,378Professionalmedian $851 · 10th to 90th $708 to $1,288
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 $851.14 Median $5,495.41 Typical High $14,125.38 | Facility | None | $851.14 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $851.14 Typical High $912.01 | Professional | None | $812.83 | $851.14 | $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 $707.95 Median $851.14 Typical High $1,096.48 | Professional | None | $707.95 | $851.14 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,258.93 Typical High $1,621.81 | Professional | 50 · Both sides | $1,071.52 | $1,258.93 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $537.03 Typical High $676.08 | Professional | 62 · Two surgeons | $446.68 | $537.03 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $173.78 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $151.36 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,202.26 | Professional | None | $812.83 | $912.01 | $1,202.26 |
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 $724.44 Median $851.14 Typical High $1,318.26 | Professional | None | $724.44 | $851.14 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,000.00 | Professional | None | $676.08 | $812.83 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | None | $912.01 | $1,148.15 | $1,148.15 |
Medcost Setting Facility Modifier None Typical Low $851.14 Median $977.24 Typical High $1,380.38 | Facility | None | $851.14 | $977.24 | $1,380.38 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Sentara Setting Facility Modifier None Typical Low $630.96 Median $1,737.80 Typical High $7,413.10 | Facility | None | $630.96 | $1,737.80 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $2,187.76 | Professional | None | $741.31 | $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 $630.96 Median $954.99 Typical High $1,479.11 | Professional | None | $630.96 | $954.99 | $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 $407.38 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $407.38 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $162.18 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $616.60 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $123.03 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $81.28 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $575.44 | $602.56 | $602.56 |
Where Virginia sits
The same service costs 16.9 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 $23,956MD $1,413
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.