How much rates vary
Facilitymedian $5,888 · 10th to 90th $955 to $13,490Professionalmedian $871 · 10th to 90th $724 to $1,318
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 $870.96 Median $5,495.41 Typical High $14,125.38 | Facility | None | $870.96 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $954.99 | Professional | None | $812.83 | $870.96 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,090.30 Median $7,413.10 Typical High $13,803.84 | Facility | None | $3,090.30 | $7,413.10 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,096.48 | Professional | None | $724.44 | $851.14 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $537.03 Typical High $691.83 | Professional | 62 · Two surgeons | $457.09 | $537.03 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $138.04 Typical High $173.78 | Professional | 80 · Assistant surgeon | $114.82 | $138.04 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $120.23 Typical High $154.88 | Professional | AS · PA/NP assist | $100.00 | $120.23 | $154.88 |
CareFirst Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $1,148.15 | Professional | None | $794.33 | $870.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,318.26 | Professional | None | $758.58 | $891.25 | $1,318.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,000.00 | Professional | None | $676.08 | $794.33 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | None | $977.24 | $1,230.27 | $1,230.27 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,412.54 | Facility | None | $870.96 | $1,122.02 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,047.13 | Professional | None | $1,047.13 | $1,047.13 | $1,047.13 |
Sentara Setting Facility Modifier None Typical Low $691.83 Median $2,089.30 Typical High $10,232.93 | Facility | None | $691.83 | $2,089.30 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $724.44 Median $1,023.29 Typical High $6,025.60 | Professional | None | $724.44 | $1,023.29 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,000.00 Typical High $1,548.82 | Professional | None | $630.96 | $1,000.00 | $1,548.82 |
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 $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $616.60 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $81.28 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $616.60 |
Where Virginia sits
The same service costs 7.8 times more in Maine than in Massachusetts. 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 $16,585MA $2,122
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.