How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,259 to $24,547Professionalmedian $2,692 · 10th to 90th $2,239 to $3,890
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 $2,630.27 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,630.27 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $3,162.28 | Professional | None | $2,398.83 | $2,630.27 | $3,162.28 |
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 $2,238.72 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,238.72 | $2,691.53 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,388.44 Median $4,073.80 Typical High $5,128.61 | Professional | 50 · Both sides | $3,388.44 | $4,073.80 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,698.24 Typical High $2,187.76 | Professional | 62 · Two surgeons | $1,412.54 | $1,698.24 | $2,187.76 |
CareFirst Setting Professional Modifier None Typical Low $2,344.23 Median $2,630.27 Typical High $3,467.37 | Professional | None | $2,344.23 | $2,630.27 | $3,467.37 |
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 $2,238.72 Median $2,691.53 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,691.53 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $3,090.30 | Professional | None | $2,089.30 | $2,511.89 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $2,818.38 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,818.38 | $3,548.13 | $3,548.13 |
Medcost Setting Facility Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $4,365.16 | Facility | None | $2,630.27 | $3,019.95 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Sentara Setting Facility Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $10,715.19 | Facility | None | $1,445.44 | $2,630.27 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $5,623.41 | Professional | None | $2,187.76 | $3,019.95 | $5,623.41 |
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 $1,949.84 Median $2,951.21 Typical High $4,570.88 | Professional | None | $1,949.84 | $2,951.21 | $4,570.88 |
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 $1,230.27 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,230.27 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $489.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,995.26 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,819.70 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $398.11 Typical High $398.11 | Professional | 55 · Aftercare only | $363.08 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $245.47 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,862.09 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,862.09 | $1,862.09 |
Where Virginia sits
The same service costs 11.6 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 $35,595MD $3,074
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.