How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,175 to $24,547Professionalmedian $2,239 · 10th to 90th $1,862 to $3,467
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 $2,238.72 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,238.72 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $4,073.80 | Professional | None | $2,041.74 | $2,238.72 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,456.54 Median $15,488.17 Typical High $28,840.32 | Facility | None | $6,456.54 | $15,488.17 | $28,840.32 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,905.46 | $2,238.72 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,412.54 Typical High $1,819.70 | Professional | 62 · Two surgeons | $1,202.26 | $1,412.54 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $363.08 Typical High $457.09 | Professional | 80 · Assistant surgeon | $302.00 | $363.08 | $457.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $316.23 Typical High $407.38 | Professional | AS · PA/NP assist | $263.03 | $316.23 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,187.76 | $2,884.03 |
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 $1,862.09 Median $2,187.76 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,187.76 | $3,388.44 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,187.76 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $2,454.71 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,454.71 | $3,090.30 | $3,090.30 |
Medcost Setting Facility Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $3,715.35 | Facility | None | $2,238.72 | $2,511.89 | $3,715.35 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,290.87 Typical High $10,232.93 | Facility | None | $1,288.25 | $2,290.87 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $4,786.30 | Professional | None | $1,862.09 | $2,454.71 | $4,786.30 |
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 $1,621.81 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,621.81 | $2,511.89 | $3,801.89 |
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 $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $1,000.00 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,513.56 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $302.00 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,584.89 | $1,584.89 |
Where Virginia sits
The same service costs 13.8 times more in Maine than in Washington. 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 $35,114WA $2,549
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.