How much rates vary
Facilitymedian $6,607 · 10th to 90th $891 to $15,849Professionalmedian $871 · 10th to 90th $708 to $1,230
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 $1,096.48 Median $5,623.41 Typical High $14,125.38 | Facility | None | $1,096.48 | $5,623.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,348.96 | Professional | None | $812.83 | $891.25 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,022.64 Typical High $15,848.93 | Facility | None | $9,772.37 | $12,022.64 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $891.25 Typical High $1,071.52 | Professional | None | $741.31 | $891.25 | $1,071.52 |
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 $467.74 Median $562.34 Typical High $676.08 | Professional | 62 · Two surgeons | $467.74 | $562.34 | $676.08 |
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 $776.25 Median $870.96 Typical High $1,148.15 | Professional | None | $776.25 | $870.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,786.30 Typical High $9,772.37 | Facility | None | $645.65 | $4,786.30 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $1,230.27 | Professional | None | $741.31 | $794.33 | $1,230.27 |
Kaiser Permanente Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,047.13 | Professional | None | $707.95 | $851.14 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,348.96 | $1,348.96 |
Medcost Setting Facility Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,445.44 | Facility | None | $891.25 | $1,023.29 | $1,445.44 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $1,202.26 | Professional | None | $954.99 | $1,202.26 | $1,202.26 |
Sentara Setting Facility Modifier None Typical Low $741.31 Median $2,818.38 Typical High $12,882.50 | Facility | None | $741.31 | $2,818.38 | $12,882.50 |
Sentara Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,862.09 | Professional | None | $776.25 | $954.99 | $1,862.09 |
United Setting Facility Modifier None Typical Low $2,630.27 Median $10,715.19 Typical High $25,118.86 | Facility | None | $2,630.27 | $10,715.19 | $25,118.86 |
United Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,412.54 | Professional | None | $549.54 | $724.44 | $1,412.54 |
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 $407.38 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $407.38 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $162.18 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 54 · Surgery only | $616.60 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $123.03 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $81.28 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $575.44 | $616.60 | $616.60 |
Where Virginia sits
The same service costs 5.9 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 $14,644MT $2,489
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.