How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,549 to $13,804Professionalmedian $1,862 · 10th to 90th $1,479 to $2,570
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 $1,862.09 Median $7,079.46 Typical High $14,125.38 | Facility | None | $1,862.09 | $7,079.46 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,698.24 Median $1,862.09 Typical High $2,570.40 | Professional | None | $1,698.24 | $1,862.09 | $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 $1,548.82 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,548.82 | $1,862.09 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $2,754.23 Typical High $3,311.31 | Professional | 50 · Both sides | $2,344.23 | $2,754.23 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,174.90 Typical High $1,412.54 | Professional | 62 · Two surgeons | $977.24 | $1,174.90 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $295.12 Typical High $354.81 | Professional | 80 · Assistant surgeon | $245.47 | $295.12 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $257.04 Typical High $309.03 | Professional | AS · PA/NP assist | $218.78 | $257.04 | $309.03 |
CareFirst Setting Professional Modifier None Typical Low $1,698.24 Median $1,905.46 Typical High $2,238.72 | Professional | None | $1,698.24 | $1,905.46 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $4,677.35 Typical High $9,332.54 | Facility | None | $512.86 | $4,677.35 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,659.59 | $2,570.40 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,445.44 | $1,698.24 | $2,137.96 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,754.23 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $1,862.09 Median $2,238.72 Typical High $3,090.30 | Facility | None | $1,862.09 | $2,238.72 | $3,090.30 |
Medcost Setting Professional Modifier None Typical Low $1,949.84 Median $2,089.30 Typical High $2,290.87 | Professional | None | $1,949.84 | $2,089.30 | $2,290.87 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $3,235.94 Typical High $10,715.19 | Facility | None | $1,288.25 | $3,235.94 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,890.45 | Professional | None | $1,513.56 | $1,995.26 | $3,890.45 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $3,019.95 | Professional | None | $1,148.15 | $1,548.82 | $3,019.95 |
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 $851.14 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $851.14 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $338.84 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,288.25 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $257.04 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $169.82 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,318.26 Typical High $1,318.26 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,318.26 | $1,318.26 |
Where Virginia sits
The same service costs 4.7 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 $16,761KY $3,604
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.