How much rates vary
Facilitymedian $6,761 · 10th to 90th $1,148 to $16,982Professionalmedian $1,202 · 10th to 90th $977 to $1,698
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 $1,202.26 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,202.26 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,202.26 | $1,548.82 |
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 $1,000.00 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,202.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $2,187.76 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $912.01 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $194.98 Typical High $234.42 | Professional | 80 · Assistant surgeon | $162.18 | $194.98 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $204.17 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $204.17 |
CareFirst Setting Professional Modifier None Typical Low $1,122.02 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,122.02 | $1,258.93 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $9,549.93 Typical High $17,782.79 | Facility | None | $512.86 | $9,549.93 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,096.48 Typical High $1,659.59 | Professional | None | $1,000.00 | $1,096.48 | $1,659.59 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,584.89 | $1,949.84 |
Medcost Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $1,995.26 | Facility | None | $1,202.26 | $1,412.54 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $3,019.95 | Professional | None | $1,318.26 | $1,584.89 | $3,019.95 |
Sentara Setting Facility Modifier None Typical Low $977.24 Median $2,511.89 Typical High $10,715.19 | Facility | None | $977.24 | $2,511.89 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $2,570.40 | Professional | None | $1,071.52 | $1,288.25 | $2,570.40 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $26,915.35 | Facility | None | $2,570.40 | $10,000.00 | $26,915.35 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,949.84 | Professional | None | $758.58 | $1,000.00 | $1,949.84 |
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 $562.34 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $562.34 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $223.87 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $831.76 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $165.96 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $112.20 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $776.25 | $851.14 | $851.14 |
Where Virginia sits
The same service costs 6.0 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 $15,585KY $2,601
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.