How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,175 to $10,965Professionalmedian $1,413 · 10th to 90th $1,148 to $2,138
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 $1,479.11 Median $5,248.07 Typical High $9,332.54 | Facility | None | $1,479.11 | $5,248.07 | $9,332.54 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $2,754.23 | Professional | None | $1,202.26 | $1,479.11 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,148.15 | $1,380.38 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $724.44 Median $870.96 Typical High $1,047.13 | Professional | 62 · Two surgeons | $724.44 | $870.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $181.97 Median $218.78 Typical High $269.15 | Professional | 80 · Assistant surgeon | $181.97 | $218.78 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $190.55 Typical High $234.42 | Professional | AS · PA/NP assist | $158.49 | $190.55 | $234.42 |
CareFirst Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,995.26 Typical High $3,715.35 | Facility | None | $524.81 | $1,995.26 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,202.26 | $1,380.38 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,584.89 | Professional | None | $1,096.48 | $1,318.26 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Professional | None | $1,995.26 | $1,995.26 | $2,398.83 |
Medcost Setting Facility Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $2,398.83 | Facility | None | $1,479.11 | $1,659.59 | $2,398.83 |
Medcost Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Sentara Setting Facility Modifier None Typical Low $1,000.00 Median $2,398.83 Typical High $10,232.93 | Facility | None | $1,000.00 | $2,398.83 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $6,760.83 | Professional | None | $1,096.48 | $1,698.24 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,445.44 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,445.44 | $2,290.87 |
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 $588.84 Median $645.65 Typical High $741.31 | Professional | 52 · Reduced service | $588.84 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $257.04 Typical High $295.12 | Professional | 53 · Discontinued | $234.42 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $954.99 Typical High $1,096.48 | Professional | 54 · Surgery only | $870.96 | $954.99 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $190.55 Typical High $218.78 | Professional | 55 · Aftercare only | $173.78 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $128.82 Typical High $147.91 | Professional | 56 · Pre-op care only | $117.49 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $891.25 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $812.83 | $891.25 | $1,023.29 |
Where Virginia sits
The same service costs 3.4 times more in Alaska than in Hawaii. 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
AK $9,915HI $2,891
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.