How much rates vary
Facilitymedian $5,623 · 10th to 90th $912 to $14,791Professionalmedian $871 · 10th to 90th $708 to $1,259
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 $891.25 Median $7,762.47 Typical High $15,488.17 | Facility | None | $891.25 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,412.54 | Professional | None | $831.76 | $891.25 | $1,412.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,096.48 | Professional | None | $758.58 | $870.96 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,318.26 Typical High $1,584.89 | Professional | 50 · Both sides | $1,071.52 | $1,318.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $676.08 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $144.54 Typical High $173.78 | Professional | 80 · Assistant surgeon | $120.23 | $144.54 | $173.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $125.89 Typical High $151.36 | Professional | AS · PA/NP assist | $104.71 | $125.89 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $776.25 Median $870.96 Typical High $1,148.15 | Professional | None | $776.25 | $870.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,019.95 Typical High $5,754.40 | Facility | None | $1,000.00 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,258.93 | Professional | None | $758.58 | $812.83 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,023.29 | Professional | None | $691.83 | $831.76 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,174.90 Typical High $1,174.90 | Professional | None | $933.25 | $1,174.90 | $1,174.90 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,479.11 | Facility | None | $891.25 | $1,000.00 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $977.24 Typical High $1,023.29 | Professional | None | $933.25 | $977.24 | $1,023.29 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $2,187.76 Typical High $10,232.93 | Facility | None | $676.08 | $2,187.76 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,905.46 | Professional | None | $676.08 | $912.01 | $1,905.46 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $1,445.44 | Professional | None | $549.54 | $707.95 | $1,445.44 |
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 $416.87 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $416.87 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $165.96 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $630.96 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $630.96 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $83.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $588.84 | $630.96 | $630.96 |
Where Virginia sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $10,315KY $2,095
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.