How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,230 to $15,488Professionalmedian $1,622 · 10th to 90th $1,175 to $2,291
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 $1,698.24 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,698.24 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,548.82 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,698.24 | $1,905.46 |
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 $1,412.54 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,412.54 | $1,698.24 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,511.89 Typical High $3,019.95 | Professional | 50 · Both sides | $2,137.96 | $2,511.89 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,071.52 Typical High $1,288.25 | Professional | 62 · Two surgeons | $891.25 | $1,071.52 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $323.59 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $323.59 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $281.84 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $281.84 |
CareFirst Setting Professional Modifier None Typical Low $1,548.82 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,737.80 | $2,041.74 |
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 $1,230.27 Median $1,513.56 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,513.56 | $2,344.23 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,584.89 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,621.81 | $1,621.81 |
Medcost Setting Facility Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $2,818.38 | Facility | None | $1,148.15 | $1,148.15 | $2,818.38 |
Medcost Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,659.59 | $1,659.59 |
Sentara Setting Facility Modifier None Typical Low $912.01 Median $3,019.95 Typical High $10,715.19 | Facility | None | $912.01 | $3,019.95 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $954.99 Median $1,659.59 Typical High $3,548.13 | Professional | None | $954.99 | $1,659.59 | $3,548.13 |
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 $794.33 Median $1,288.25 Typical High $2,754.23 | Professional | None | $794.33 | $1,288.25 | $2,754.23 |
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 $776.25 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $309.03 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,174.90 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $234.42 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,202.26 | $1,202.26 |
Where Virginia sits
The same service costs 5.5 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 $15,938KY $2,890
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.