How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,023 to $17,378Professionalmedian $912 · 10th to 90th $708 to $1,413
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 $4,786.30 Typical High $11,481.54 | Facility | None | $1,096.48 | $4,786.30 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $3,801.89 | Professional | None | $676.08 | $870.96 | $3,801.89 |
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 $758.58 Median $912.01 Typical High $1,148.15 | Professional | None | $758.58 | $912.01 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $724.44 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $144.54 Typical High $186.21 | Professional | 80 · Assistant surgeon | $120.23 | $144.54 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $125.89 Typical High $162.18 | Professional | AS · PA/NP assist | $104.71 | $125.89 | $162.18 |
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 $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 $741.31 Median $891.25 Typical High $1,348.96 | Professional | None | $741.31 | $891.25 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,047.13 | Professional | None | $707.95 | $851.14 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,258.93 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,445.44 | Facility | None | $870.96 | $1,023.29 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $10,232.93 | Facility | None | $676.08 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $707.95 Median $1,000.00 Typical High $6,025.60 | Professional | None | $707.95 | $1,000.00 | $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 $645.65 Median $1,000.00 Typical High $1,548.82 | Professional | None | $645.65 | $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 $338.84 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $338.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $134.90 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $501.19 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $100.00 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $67.61 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $467.74 | $616.60 | $616.60 |
Where Virginia sits
The same service costs 11.6 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 $23,484TX $2,029
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.