How much rates vary
Facilitymedian $4,074 · 10th to 90th $871 to $12,023Professionalmedian $1,096 · 10th to 90th $891 to $1,698
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 $1,096.48 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,096.48 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $2,137.96 | Professional | None | $1,023.29 | $1,096.48 | $2,137.96 |
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 $891.25 Median $1,071.52 Typical High $1,380.38 | Professional | None | $891.25 | $1,071.52 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $676.08 Typical High $870.96 | Professional | 62 · Two surgeons | $562.34 | $676.08 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $223.87 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $151.36 Typical High $190.55 | Professional | AS · PA/NP assist | $125.89 | $151.36 | $190.55 |
CareFirst Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,412.54 | Professional | None | $977.24 | $1,096.48 | $1,412.54 |
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 $933.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $933.25 | $1,096.48 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,258.93 | Professional | None | $851.14 | $1,000.00 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,778.28 | Facility | None | $1,096.48 | $1,412.54 | $1,778.28 |
Medcost Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Sentara Setting Facility Modifier None Typical Low $870.96 Median $1,737.80 Typical High $5,495.41 | Facility | None | $870.96 | $1,737.80 | $5,495.41 |
Sentara Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $2,344.23 | Professional | None | $891.25 | $1,258.93 | $2,344.23 |
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 $794.33 Median $1,230.27 Typical High $1,949.84 | Professional | None | $794.33 | $1,230.27 | $1,949.84 |
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 $512.86 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $512.86 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $776.25 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $154.88 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $724.44 | $758.58 | $758.58 |
Where Virginia sits
The same service costs 10.3 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 $16,837MD $1,634
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.