How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,148 to $24,547Professionalmedian $2,138 · 10th to 90th $1,738 to $3,162
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 $2,089.30 Median $4,786.30 Typical High $14,125.38 | Facility | None | $2,089.30 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,905.46 Median $2,089.30 Typical High $3,801.89 | Professional | None | $1,905.46 | $2,089.30 | $3,801.89 |
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 $1,778.28 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,778.28 | $2,137.96 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,348.96 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,122.02 | $1,348.96 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $288.40 Median $338.84 Typical High $436.52 | Professional | 80 · Assistant surgeon | $288.40 | $338.84 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $302.00 Typical High $380.19 | Professional | AS · PA/NP assist | $251.19 | $302.00 | $380.19 |
CareFirst Setting Professional Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,754.23 | Professional | None | $1,862.09 | $2,089.30 | $2,754.23 |
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 $1,778.28 Median $2,089.30 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,089.30 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,698.24 | $2,041.74 | $2,511.89 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,398.83 | $3,019.95 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $3,467.37 | Facility | None | $2,089.30 | $2,398.83 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $10,232.93 | Facility | None | $1,288.25 | $2,187.76 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $4,570.88 | Professional | None | $1,778.28 | $2,344.23 | $4,570.88 |
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 $1,513.56 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,513.56 | $2,344.23 | $3,548.13 |
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 $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $954.99 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $380.19 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,412.54 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $190.55 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,479.11 | $1,479.11 |
Where Virginia sits
The same service costs 13.4 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 $34,930MD $2,604
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.