How much rates vary
Facilitymedian $5,754 · 10th to 90th $1,175 to $15,488Professionalmedian $1,259 · 10th to 90th $1,023 to $1,778
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 $1,584.89 Median $5,495.41 Typical High $11,481.54 | Facility | None | $1,584.89 | $5,495.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,258.93 | $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 $1,071.52 Median $1,258.93 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,258.93 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $1,905.46 Typical High $2,290.87 | Professional | 50 · Both sides | $1,584.89 | $1,905.46 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $676.08 Median $794.33 Typical High $954.99 | Professional | 62 · Two surgeons | $676.08 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $169.82 Median $204.17 Typical High $245.47 | Professional | 80 · Assistant surgeon | $169.82 | $204.17 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $147.91 Median $177.83 Typical High $213.80 | Professional | AS · PA/NP assist | $147.91 | $177.83 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,318.26 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $5,011.87 Typical High $9,332.54 | Facility | None | $512.86 | $5,011.87 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,148.15 | $1,778.28 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,202.26 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,513.56 | $1,905.46 | $1,905.46 |
Medcost Setting Facility Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,089.30 | Facility | None | $1,258.93 | $1,513.56 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $1,737.80 | Professional | None | $1,380.38 | $1,621.81 | $1,737.80 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $2,570.40 Typical High $10,715.19 | Facility | None | $933.25 | $2,570.40 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,691.53 | Professional | None | $1,122.02 | $1,380.38 | $2,691.53 |
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 $794.33 Median $1,047.13 Typical High $2,041.74 | Professional | None | $794.33 | $1,047.13 | $2,041.74 |
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 $588.84 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $234.42 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $891.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $891.25 |
Where Virginia sits
The same service costs 5.1 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 $14,343KY $2,808
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.