How much rates vary
Facilitymedian $3,236 · 10th to 90th $661 to $9,550Professionalmedian $661 · 10th to 90th $537 to $933
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 $660.69 Median $4,365.16 Typical High $10,000.00 | Facility | None | $660.69 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $977.24 | Professional | None | $630.96 | $660.69 | $977.24 |
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 $562.34 Median $676.08 Typical High $812.83 | Professional | None | $562.34 | $676.08 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,023.29 Typical High $1,202.26 | Professional | 50 · Both sides | $851.14 | $1,023.29 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $426.58 Typical High $512.86 | Professional | 62 · Two surgeons | $354.81 | $426.58 | $512.86 |
CareFirst Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $870.96 | Professional | None | $602.56 | $660.69 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,659.59 Typical High $3,090.30 | Facility | None | $478.63 | $1,659.59 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $602.56 Typical High $933.25 | Professional | None | $549.54 | $602.56 | $933.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $831.76 | Professional | None | $549.54 | $660.69 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | None | $776.25 | $977.24 | $977.24 |
Medcost Setting Facility Modifier None Typical Low $660.69 Median $758.58 Typical High $1,071.52 | Facility | None | $660.69 | $758.58 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $891.25 | Professional | None | $707.95 | $831.76 | $891.25 |
Sentara Setting Facility Modifier None Typical Low $549.54 Median $1,737.80 Typical High $8,709.64 | Facility | None | $549.54 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,412.54 | Professional | None | $575.44 | $707.95 | $1,412.54 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $407.38 Median $537.03 Typical High $1,071.52 | Professional | None | $407.38 | $537.03 | $1,071.52 |
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 $316.23 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $316.23 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $457.09 |
Where Virginia sits
The same service costs 3.7 times more in Alabama than in Montana. 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
AL $7,148MT $1,932
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.