How much rates vary
Facilitymedian $5,888 · 10th to 90th $891 to $21,380Professionalmedian $891 · 10th to 90th $708 to $1,259
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 $891.25 Median $5,495.41 Typical High $14,125.38 | Facility | None | $891.25 | $5,495.41 | $14,125.38 |
Aetna 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 |
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 $724.44 Median $870.96 Typical High $1,047.13 | Professional | None | $724.44 | $870.96 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,096.48 Median $1,318.26 Typical High $1,584.89 | Professional | 50 · Both sides | $1,096.48 | $1,318.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $549.54 Typical High $660.69 | Professional | 62 · Two surgeons | $457.09 | $549.54 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $141.25 Typical High $169.82 | Professional | 80 · Assistant surgeon | $117.49 | $141.25 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $147.91 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $147.91 |
CareFirst Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,071.52 | Professional | None | $812.83 | $912.01 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $1,862.09 Typical High $3,162.28 | Facility | None | $512.86 | $1,862.09 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $1,258.93 | Professional | None | $741.31 | $776.25 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,023.29 | Professional | None | $691.83 | $831.76 | $1,023.29 |
Medcost Setting Professional Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,071.52 | $1,318.26 | $1,318.26 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,479.11 | Facility | None | $891.25 | $1,096.48 | $1,479.11 |
Medcost Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,230.27 | $1,258.93 |
Sentara Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $18,620.87 | Facility | None | $724.44 | $2,137.96 | $18,620.87 |
Sentara Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,905.46 | Professional | None | $776.25 | $1,000.00 | $1,905.46 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $13,182.57 Typical High $33,113.11 | Facility | None | $4,570.88 | $13,182.57 | $33,113.11 |
United Setting Professional Modifier None Typical Low $562.34 Median $758.58 Typical High $1,445.44 | Professional | None | $562.34 | $758.58 | $1,445.44 |
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 $398.11 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $398.11 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $602.56 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $120.23 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $562.34 | $630.96 | $630.96 |
Where Virginia sits
The same service costs 4.3 times more in Alaska than in Texas. 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 $9,769TX $2,271
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.