How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,288 to $17,378Professionalmedian $1,318 · 10th to 90th $1,047 to $2,089
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 $1,288.25 Median $4,365.16 Typical High $14,125.38 | Facility | None | $1,288.25 | $4,365.16 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,288.25 Typical High $2,290.87 | Professional | None | $954.99 | $1,288.25 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,466.84 Median $10,715.19 Typical High $19,952.62 | Facility | None | $4,466.84 | $10,715.19 | $19,952.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,288.25 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $812.83 Typical High $1,047.13 | Professional | 62 · Two surgeons | $676.08 | $812.83 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $208.93 Typical High $263.03 | Professional | 80 · Assistant surgeon | $173.78 | $208.93 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $181.97 Typical High $234.42 | Professional | AS · PA/NP assist | $151.36 | $181.97 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $6,165.95 | Professional | None | $1,174.90 | $1,318.26 | $6,165.95 |
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 $1,047.13 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,318.26 | $1,995.26 |
Kaiser Permanente Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,445.44 | Professional | None | $977.24 | $1,148.15 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,584.89 | $1,949.84 | $1,949.84 |
Medcost Setting Facility Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,089.30 | Facility | None | $1,288.25 | $1,584.89 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,238.72 Typical High $10,232.93 | Facility | None | $933.25 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $6,456.54 | Professional | None | $1,096.48 | $1,513.56 | $6,456.54 |
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 $954.99 Median $1,548.82 Typical High $2,238.72 | Professional | None | $954.99 | $1,548.82 | $2,238.72 |
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 $478.63 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $478.63 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $190.55 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $724.44 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $144.54 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $95.50 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $676.08 | $891.25 | $891.25 |
Where Virginia sits
The same service costs 9.2 times more in Maine than in Texas. 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 $22,965TX $2,508
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.