How much rates vary
Facilitymedian $3,981 · 10th to 90th $661 to $17,378Professionalmedian $1,445 · 10th to 90th $1,175 to $2,188
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 $1,445.44 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,445.44 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,445.44 | $1,584.89 |
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 $1,174.90 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,412.54 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $891.25 Typical High $1,148.15 | Professional | 62 · Two surgeons | $741.31 | $891.25 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $229.09 Typical High $288.40 | Professional | 80 · Assistant surgeon | $190.55 | $229.09 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $199.53 Typical High $251.19 | Professional | AS · PA/NP assist | $165.96 | $199.53 | $251.19 |
CareFirst Setting Professional Modifier None Typical Low $1,288.25 Median $1,445.44 Typical High $1,862.09 | Professional | None | $1,288.25 | $1,445.44 | $1,862.09 |
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 $1,230.27 Median $1,479.11 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,479.11 | $2,187.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,122.02 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,122.02 | $1,318.26 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,621.81 | $2,041.74 | $2,041.74 |
Medcost Setting Facility Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $2,398.83 | Facility | None | $1,445.44 | $1,905.46 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,737.80 | $1,737.80 | $1,737.80 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $1,548.82 Typical High $7,413.10 | Facility | None | $676.08 | $1,548.82 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,148.15 Median $1,698.24 Typical High $3,090.30 | Professional | None | $1,148.15 | $1,698.24 | $3,090.30 |
United Setting Facility Modifier None Typical Low $323.59 Median $1,412.54 Typical High $3,630.78 | Facility | None | $323.59 | $1,412.54 | $3,630.78 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,047.13 | $1,659.59 | $2,570.40 |
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 $676.08 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $676.08 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $269.15 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $1,023.29 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $204.17 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $954.99 | $1,023.29 | $1,023.29 |
Where Virginia sits
The same service costs 13.1 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 $24,687MD $1,882
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.