How much rates vary
Facilitymedian $5,623 · 10th to 90th $1,122 to $24,547Professionalmedian $1,738 · 10th to 90th $1,413 to $2,570
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 $1,698.24 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,698.24 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,548.82 | $1,698.24 | $2,089.30 |
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 $1,445.44 Median $1,737.80 Typical High $2,238.72 | Professional | None | $1,445.44 | $1,737.80 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,096.48 Typical High $1,412.54 | Professional | 62 · Two surgeons | $912.01 | $1,096.48 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $275.42 Typical High $354.81 | Professional | 80 · Assistant surgeon | $234.42 | $275.42 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $245.47 Typical High $309.03 | Professional | AS · PA/NP assist | $204.17 | $245.47 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,698.24 | $2,238.72 |
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 $1,445.44 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,698.24 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,698.24 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,995.26 | $2,511.89 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,818.38 | Facility | None | $1,698.24 | $1,905.46 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Sentara Setting Facility Modifier None Typical Low $1,096.48 Median $2,089.30 Typical High $10,232.93 | Facility | None | $1,096.48 | $2,089.30 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,995.26 Typical High $3,801.89 | Professional | None | $1,288.25 | $1,995.26 | $3,801.89 |
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 $1,230.27 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,949.84 | $2,884.03 |
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 $776.25 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,148.15 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $229.09 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,202.26 | $1,202.26 |
Where Virginia sits
The same service costs 15.5 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 $34,449MD $2,222
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.