How much rates vary
Facilitymedian $7,079 · 10th to 90th $1,995 to $15,488Professionalmedian $2,692 · 10th to 90th $2,188 to $3,715
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 $2,754.23 Median $7,079.46 Typical High $14,125.38 | Facility | None | $2,754.23 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $3,548.13 | Professional | None | $2,511.89 | $2,754.23 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,311.31 | Professional | None | $2,290.87 | $2,754.23 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,737.80 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,445.44 | $1,737.80 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $446.68 Typical High $537.03 | Professional | 80 · Assistant surgeon | $371.54 | $446.68 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $389.05 Typical High $467.74 | Professional | AS · PA/NP assist | $323.59 | $389.05 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $3,311.31 | Professional | None | $2,570.40 | $2,818.38 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,548.13 Typical High $7,079.46 | Facility | None | $512.86 | $3,548.13 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,454.71 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,454.71 | $3,801.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,570.40 | $3,235.94 |
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 $2,754.23 Median $3,162.28 Typical High $4,570.88 | Facility | None | $2,754.23 | $3,162.28 | $4,570.88 |
Medcost Setting Professional Modifier None Typical Low $2,818.38 Median $2,951.21 Typical High $3,090.30 | Professional | None | $2,818.38 | $2,951.21 | $3,090.30 |
Sentara Setting Facility Modifier None Typical Low $1,778.28 Median $3,548.13 Typical High $12,022.64 | Facility | None | $1,778.28 | $3,548.13 | $12,022.64 |
Sentara Setting Professional Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $5,754.40 | Professional | None | $2,344.23 | $2,818.38 | $5,754.40 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $4,466.84 | Professional | None | $1,659.59 | $2,187.76 | $4,466.84 |
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 $1,258.93 Median $1,380.38 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,258.93 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $512.86 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,905.46 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 55 · Aftercare only | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $251.19 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,949.84 | $1,949.84 |
Where Virginia sits
The same service costs 4.0 times more in Alaska 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
AK $19,772TX $4,915
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.