How much rates vary
Facilitymedian $4,074 · 10th to 90th $891 to $11,482Professionalmedian $1,122 · 10th to 90th $933 to $1,660
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 $1,096.48 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,096.48 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,000.00 | $1,096.48 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $7,079.46 Typical High $12,882.50 | Facility | None | $2,884.03 | $7,079.46 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,445.44 | Professional | None | $954.99 | $1,148.15 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $724.44 Typical High $912.01 | Professional | 62 · Two surgeons | $602.56 | $724.44 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $181.97 Typical High $234.42 | Professional | 80 · Assistant surgeon | $151.36 | $181.97 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $158.49 Typical High $204.17 | Professional | AS · PA/NP assist | $131.83 | $158.49 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $1,000.00 Median $1,122.02 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,122.02 | $1,445.44 |
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 $954.99 Median $1,096.48 Typical High $1,659.59 | Professional | None | $954.99 | $1,096.48 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $954.99 Median $1,148.15 Typical High $1,412.54 | Professional | None | $954.99 | $1,148.15 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,202.26 | $1,513.56 | $1,513.56 |
Medcost Setting Facility Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,819.70 | Facility | None | $1,096.48 | $1,230.27 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,148.15 | $1,148.15 | $1,148.15 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $1,737.80 Typical High $5,623.41 | Facility | None | $851.14 | $1,737.80 | $5,623.41 |
Sentara Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $2,511.89 | Professional | None | $933.25 | $1,288.25 | $2,511.89 |
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 $794.33 Median $1,230.27 Typical High $1,862.09 | Professional | None | $794.33 | $1,230.27 | $1,862.09 |
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 $501.19 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $501.19 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $199.53 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $100.00 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $691.83 | $776.25 | $776.25 |
Where Virginia sits
The same service costs 9.7 times more in Maine than in Arkansas. 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 $16,140AR $1,661
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.