How much rates vary
Facilitymedian $10,233 · 10th to 90th $1,585 to $25,119Professionalmedian $1,479 · 10th to 90th $1,230 to $2,344
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 $1,479.11 Median $7,079.46 Typical High $16,218.10 | Facility | None | $1,479.11 | $7,079.46 | $16,218.10 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $3,981.07 | Professional | None | $1,348.96 | $1,479.11 | $3,981.07 |
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 $1,230.27 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,479.11 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $302.00 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $204.17 Typical High $263.03 | Professional | AS · PA/NP assist | $173.78 | $204.17 | $263.03 |
CareFirst Setting Professional Modifier None Typical Low $1,230.27 Median $1,348.96 Typical High $3,162.28 | Professional | None | $1,230.27 | $1,348.96 | $3,162.28 |
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 $1,230.27 Median $1,445.44 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,445.44 | $2,238.72 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,380.38 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,737.80 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $2,454.71 | Facility | None | $1,479.11 | $1,737.80 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,951.21 Typical High $12,882.50 | Facility | None | $1,023.29 | $2,951.21 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $7,413.10 | Professional | None | $1,288.25 | $1,737.80 | $7,413.10 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,071.52 | $1,659.59 | $2,511.89 |
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 $660.69 Median $741.31 Typical High $741.31 | Professional | 52 · Reduced service | $660.69 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 53 · Discontinued | $269.15 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,000.00 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 55 · Aftercare only | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | 56 · Pre-op care only | $134.90 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $933.25 | $1,047.13 | $1,047.13 |
Where Virginia sits
The same service costs 13.5 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 $34,179TX $2,531
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.