How much rates vary
Facilitymedian $3,981 · 10th to 90th $933 to $10,965Professionalmedian $1,349 · 10th to 90th $832 to $1,905
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 $1,412.54 Median $4,786.30 Typical High $10,000.00 | Facility | None | $1,412.54 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,412.54 | $1,949.84 |
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 $1,174.90 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,412.54 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,137.96 Typical High $2,570.40 | Professional | 50 · Both sides | $1,778.28 | $2,137.96 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $891.25 Typical High $1,071.52 | Professional | 62 · Two surgeons | $741.31 | $891.25 | $1,071.52 |
CareFirst Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,258.93 | $1,380.38 | $1,621.81 |
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 $616.60 Median $1,258.93 Typical High $1,905.46 | Professional | None | $616.60 | $1,258.93 | $1,905.46 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,318.26 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | None | $812.83 | $1,023.29 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $2,344.23 | Facility | None | $776.25 | $776.25 | $2,344.23 |
Medcost Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $1,230.27 | Professional | None | $724.44 | $741.31 | $1,230.27 |
Sentara Setting Facility Modifier None Typical Low $575.44 Median $2,398.83 Typical High $10,232.93 | Facility | None | $575.44 | $2,398.83 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $562.34 Median $1,288.25 Typical High $2,951.21 | Professional | None | $562.34 | $1,288.25 | $2,951.21 |
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 $537.03 Median $1,023.29 Typical High $2,290.87 | Professional | None | $537.03 | $1,023.29 | $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 $645.65 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $645.65 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $263.03 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $977.24 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $912.01 | $1,000.00 | $1,000.00 |
Where Virginia sits
The same service costs 3.7 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 $9,494KY $2,537
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.