How much rates vary
Facilitymedian $5,495 · 10th to 90th $1,096 to $19,953Professionalmedian $1,380 · 10th to 90th $1,122 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 $1,380.38 Median $7,413.10 Typical High $15,848.93 | Facility | None | $1,380.38 | $7,413.10 | $15,848.93 |
Aetna Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,380.38 | $3,235.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,248.07 Median $12,589.25 Typical High $23,442.29 | Facility | None | $5,248.07 | $12,589.25 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,122.02 | $1,348.96 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $1,995.26 Typical High $2,570.40 | Professional | 50 · Both sides | $1,659.59 | $1,995.26 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $851.14 Typical High $1,071.52 | Professional | 62 · Two surgeons | $707.95 | $851.14 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $213.80 Typical High $275.42 | Professional | 80 · Assistant surgeon | $177.83 | $213.80 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $186.21 Typical High $239.88 | Professional | AS · PA/NP assist | $154.88 | $186.21 | $239.88 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,230.27 | $1,348.96 | $1,778.28 |
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 $1,174.90 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,380.38 | $2,089.30 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,548.82 | Professional | None | $1,047.13 | $1,230.27 | $1,548.82 |
Medcost Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,548.82 | $1,949.84 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,238.72 | Facility | None | $1,380.38 | $1,778.28 | $2,238.72 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,862.09 Typical High $7,413.10 | Facility | None | $933.25 | $1,862.09 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,202.26 Median $1,584.89 Typical High $2,951.21 | Professional | None | $1,202.26 | $1,584.89 | $2,951.21 |
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 $1,000.00 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,000.00 | $1,584.89 | $2,454.71 |
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 $630.96 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $630.96 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $257.04 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $954.99 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $190.55 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $891.25 | $954.99 | $954.99 |
Where Virginia sits
The same service costs 14.8 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 $28,001MD $1,894
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.