How much rates vary
Facilitymedian $4,571 · 10th to 90th $933 to $15,488Professionalmedian $933 · 10th to 90th $759 to $1,318
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 $977.24 Median $5,495.41 Typical High $14,125.38 | Facility | None | $977.24 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | None | $870.96 | $977.24 | $977.24 |
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 $794.33 Median $933.25 Typical High $1,122.02 | Professional | None | $794.33 | $933.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,412.54 Typical High $1,698.24 | Professional | 50 · Both sides | $1,174.90 | $1,412.54 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $501.19 Median $588.84 Typical High $707.95 | Professional | 62 · Two surgeons | $501.19 | $588.84 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $151.36 Typical High $181.97 | Professional | 80 · Assistant surgeon | $125.89 | $151.36 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $131.83 Typical High $158.49 | Professional | AS · PA/NP assist | $109.65 | $131.83 | $158.49 |
CareFirst Setting Professional Modifier None Typical Low $891.25 Median $977.24 Typical High $1,148.15 | Professional | None | $891.25 | $977.24 | $1,148.15 |
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 $794.33 Median $831.76 Typical High $1,380.38 | Professional | None | $794.33 | $831.76 | $1,380.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,071.52 | Professional | None | $724.44 | $870.96 | $1,071.52 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,479.11 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,584.89 | Facility | None | $977.24 | $1,174.90 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $1,122.02 Median $1,380.38 Typical High $2,089.30 | Professional | None | $1,122.02 | $1,380.38 | $2,089.30 |
Sentara Setting Facility Modifier None Typical Low $831.76 Median $2,344.23 Typical High $10,715.19 | Facility | None | $831.76 | $2,344.23 | $10,715.19 |
Sentara Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $2,089.30 | Professional | None | $831.76 | $1,071.52 | $2,089.30 |
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 $602.56 Median $812.83 Typical High $1,548.82 | Professional | None | $602.56 | $812.83 | $1,548.82 |
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 $436.52 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $131.83 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $676.08 | $676.08 |
Where Virginia sits
The same service costs 5.0 times more in Alabama 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
AL $11,256KY $2,261
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.