How much rates vary
Facilitymedian $7,413 · 10th to 90th $955 to $16,982Professionalmedian $1,000 · 10th to 90th $813 to $1,445
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 $1,000.00 Median $5,623.41 Typical High $10,964.78 | Facility | None | $1,000.00 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,000.00 Typical High $1,819.70 | Professional | None | $933.25 | $1,000.00 | $1,819.70 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,023.29 Typical High $1,230.27 | Professional | None | $851.14 | $1,023.29 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,513.56 Typical High $1,819.70 | Professional | 50 · Both sides | $1,258.93 | $1,513.56 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $645.65 Typical High $776.25 | Professional | 62 · Two surgeons | $537.03 | $645.65 | $776.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $162.18 Typical High $194.98 | Professional | 80 · Assistant surgeon | $134.90 | $162.18 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $141.25 Typical High $169.82 | Professional | AS · PA/NP assist | $117.49 | $141.25 | $169.82 |
CareFirst Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $1,318.26 | Professional | None | $891.25 | $1,000.00 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,311.31 Typical High $16,982.44 | Facility | None | $645.65 | $3,311.31 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,412.54 | Professional | None | $831.76 | $912.01 | $1,412.54 |
Kaiser Permanente Setting Professional Modifier None Typical Low $794.33 Median $954.99 Typical High $1,202.26 | Professional | None | $794.33 | $954.99 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,174.90 | $1,479.11 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,659.59 | Facility | None | $1,000.00 | $1,174.90 | $1,659.59 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,202.26 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,202.26 | $1,230.27 |
Sentara Setting Facility Modifier None Typical Low $812.83 Median $2,454.71 Typical High $12,882.50 | Facility | None | $812.83 | $2,454.71 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $870.96 Median $1,071.52 Typical High $2,137.96 | Professional | None | $870.96 | $1,071.52 | $2,137.96 |
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 $630.96 Median $812.83 Typical High $1,621.81 | Professional | None | $630.96 | $812.83 | $1,621.81 |
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 $467.74 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $467.74 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $186.21 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $93.33 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $707.95 |
Where Virginia sits
The same service costs 6.8 times more in Alaska than in Montana. 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 $19,480MT $2,858
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.