How much rates vary
Facilitymedian $5,495 · 10th to 90th $933 to $12,882Professionalmedian $955 · 10th to 90th $776 to $1,380
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 $933.25 Median $5,623.41 Typical High $10,964.78 | Facility | None | $933.25 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,348.96 | Professional | None | $933.25 | $933.25 | $1,348.96 |
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 $831.76 Median $1,000.00 Typical High $1,202.26 | Professional | None | $831.76 | $1,000.00 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $630.96 Typical High $758.58 | Professional | 62 · Two surgeons | $524.81 | $630.96 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $158.49 Typical High $190.55 | Professional | 80 · Assistant surgeon | $131.83 | $158.49 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $138.04 Typical High $165.96 | Professional | AS · PA/NP assist | $117.49 | $138.04 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,288.25 | Professional | None | $891.25 | $977.24 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,311.31 Typical High $8,912.51 | Facility | None | $645.65 | $3,311.31 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,380.38 | Professional | None | $794.33 | $891.25 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,258.93 | Professional | None | $831.76 | $1,000.00 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,445.44 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $933.25 Median $1,071.52 Typical High $1,513.56 | Facility | None | $933.25 | $1,071.52 | $1,513.56 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,047.13 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,047.13 | $1,479.11 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $10,232.93 | Facility | None | $851.14 | $2,238.72 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $2,089.30 | Professional | None | $851.14 | $1,023.29 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,548.82 | Professional | None | $588.84 | $812.83 | $1,548.82 |
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 $457.09 Median $457.09 Typical High $467.74 | Professional | 52 · Reduced service | $457.09 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $190.55 | Professional | 53 · Discontinued | $186.21 | $186.21 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $691.83 Typical High $707.95 | Professional | 54 · Surgery only | $691.83 | $691.83 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $645.65 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $645.65 | $645.65 | $660.69 |
Where Virginia sits
The same service costs 4.5 times more in Alaska 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
AK $12,963MT $2,892
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.