How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,259 to $24,547Professionalmedian $2,570 · 10th to 90th $2,042 to $3,467
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 $2,570.40 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,570.40 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,344.23 | $2,570.40 | $2,570.40 |
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 $2,137.96 Median $2,570.40 Typical High $3,090.30 | Professional | None | $2,137.96 | $2,570.40 | $3,090.30 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,621.81 Typical High $1,949.84 | Professional | 62 · Two surgeons | $1,348.96 | $1,621.81 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $416.87 Typical High $501.19 | Professional | 80 · Assistant surgeon | $346.74 | $416.87 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $363.08 Typical High $436.52 | Professional | AS · PA/NP assist | $302.00 | $363.08 | $436.52 |
CareFirst Setting Professional Modifier None Typical Low $2,398.83 Median $2,630.27 Typical High $2,754.23 | Professional | None | $2,398.83 | $2,630.27 | $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 $2,041.74 Median $2,290.87 Typical High $3,467.37 | Professional | None | $2,041.74 | $2,290.87 | $3,467.37 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $3,090.30 | Professional | None | $2,041.74 | $2,454.71 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $2,951.21 Median $3,715.35 Typical High $3,715.35 | Professional | None | $2,951.21 | $3,715.35 | $3,715.35 |
Medcost Setting Facility Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $4,168.69 | Facility | None | $2,570.40 | $2,951.21 | $4,168.69 |
Medcost Setting Professional Modifier None Typical Low $2,754.23 Median $2,818.38 Typical High $3,630.78 | Professional | None | $2,754.23 | $2,818.38 | $3,630.78 |
Sentara Setting Facility Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $10,232.93 | Facility | None | $1,445.44 | $2,630.27 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $5,248.07 | Professional | None | $2,187.76 | $2,818.38 | $5,248.07 |
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 $2,089.30 Typical High $4,073.80 | Professional | None | $1,513.56 | $2,089.30 | $4,073.80 |
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 $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,174.90 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $467.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,905.46 Typical High $1,905.46 | Professional | 54 · Surgery only | $1,778.28 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $354.81 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $234.42 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,819.70 | $1,819.70 |
Where Virginia sits
The same service costs 13.8 times more in Maine than in Texas. 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 $35,114TX $2,545
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.