How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,479 to $15,488Professionalmedian $2,239 · 10th to 90th $1,479 to $3,090
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 $2,344.23 Median $7,079.46 Typical High $14,125.38 | Facility | None | $2,344.23 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,344.23 | $2,570.40 |
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 $1,905.46 Median $2,290.87 Typical High $2,754.23 | Professional | None | $1,905.46 | $2,290.87 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $3,467.37 Typical High $4,168.69 | Professional | 50 · Both sides | $2,884.03 | $3,467.37 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,445.44 Typical High $1,737.80 | Professional | 62 · Two surgeons | $1,202.26 | $1,445.44 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $371.54 Typical High $436.52 | Professional | 80 · Assistant surgeon | $309.03 | $371.54 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $323.59 Typical High $389.05 | Professional | AS · PA/NP assist | $269.15 | $323.59 | $389.05 |
CareFirst Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,137.96 | $2,344.23 | $2,754.23 |
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 $1,380.38 Median $2,041.74 Typical High $3,162.28 | Professional | None | $1,380.38 | $2,041.74 | $3,162.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,630.27 | Professional | None | $1,778.28 | $2,089.30 | $2,630.27 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,318.26 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $3,801.89 | Facility | None | $1,348.96 | $1,348.96 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,318.26 | $1,584.89 | $2,238.72 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $3,467.37 Typical High $10,715.19 | Facility | None | $933.25 | $3,467.37 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,071.52 Median $2,344.23 Typical High $4,786.30 | Professional | None | $1,071.52 | $2,344.23 | $4,786.30 |
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 $933.25 Median $1,698.24 Typical High $3,715.35 | Professional | None | $933.25 | $1,698.24 | $3,715.35 |
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 $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,584.89 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $316.23 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,621.81 | $1,621.81 |
Where Virginia sits
The same service costs 4.9 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 $18,090KY $3,723
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.