How much rates vary
Facilitymedian $6,026 · 10th to 90th $1,259 to $24,547Professionalmedian $3,631 · 10th to 90th $2,951 to $5,370
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 $3,311.31 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,311.31 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $3,235.94 Median $3,630.78 Typical High $4,365.16 | Professional | None | $3,235.94 | $3,630.78 | $4,365.16 |
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 $3,019.95 Median $3,630.78 Typical High $4,570.88 | Professional | None | $3,019.95 | $3,630.78 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,905.46 Median $2,290.87 Typical High $2,884.03 | Professional | 62 · Two surgeons | $1,905.46 | $2,290.87 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $478.63 Median $575.44 Typical High $741.31 | Professional | 80 · Assistant surgeon | $478.63 | $575.44 | $741.31 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $416.87 Median $501.19 Typical High $645.65 | Professional | AS · PA/NP assist | $416.87 | $501.19 | $645.65 |
CareFirst Setting Professional Modifier None Typical Low $3,162.28 Median $3,467.37 Typical High $4,570.88 | Professional | None | $3,162.28 | $3,467.37 | $4,570.88 |
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 $2,951.21 Median $3,548.13 Typical High $5,495.41 | Professional | None | $2,951.21 | $3,548.13 | $5,495.41 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $4,168.69 | Professional | None | $2,818.38 | $3,388.44 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $4,265.80 Median $5,370.32 Typical High $5,370.32 | Professional | None | $4,265.80 | $5,370.32 | $5,370.32 |
Medcost Setting Facility Modifier None Typical Low $3,630.78 Median $4,073.80 Typical High $6,025.60 | Facility | None | $3,630.78 | $4,073.80 | $6,025.60 |
Medcost Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
Sentara Setting Facility Modifier None Typical Low $1,737.80 Median $3,548.13 Typical High $11,481.54 | Facility | None | $1,737.80 | $3,548.13 | $11,481.54 |
Sentara Setting Professional Modifier None Typical Low $2,818.38 Median $3,981.07 Typical High $7,413.10 | Professional | None | $2,818.38 | $3,981.07 | $7,413.10 |
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 $2,630.27 Median $4,073.80 Typical High $6,165.95 | Professional | None | $2,630.27 | $4,073.80 | $6,165.95 |
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 $1,621.81 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,621.81 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $645.65 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,398.83 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $478.63 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $323.59 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,511.89 | $2,511.89 |
Where Virginia sits
The same service costs 10.8 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 $36,725WA $3,399
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.