How much rates vary
Facilitymedian $5,248 · 10th to 90th $871 to $13,490Professionalmedian $912 · 10th to 90th $741 to $1,413
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 $5,370.32 Typical High $14,125.38 | Facility | None | $1,000.00 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $3,981.07 | Professional | None | $870.96 | $891.25 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,148.15 | Professional | None | $758.58 | $912.01 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $478.63 Median $562.34 Typical High $724.44 | Professional | 62 · Two surgeons | $478.63 | $562.34 | $724.44 |
CareFirst Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $6,918.31 | Professional | None | $758.58 | $831.76 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $2,691.53 Typical High $5,754.40 | Facility | None | $524.81 | $2,691.53 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,348.96 | Professional | None | $776.25 | $912.01 | $1,348.96 |
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 $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,288.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,412.54 | Facility | None | $870.96 | $1,023.29 | $1,412.54 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Sentara Setting Facility Modifier None Typical Low $724.44 Median $2,137.96 Typical High $10,232.93 | Facility | None | $724.44 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $758.58 Median $1,000.00 Typical High $7,413.10 | Professional | None | $758.58 | $1,000.00 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $20,417.38 | Facility | None | $1,995.26 | $8,511.38 | $20,417.38 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,548.82 | Professional | None | $645.65 | $1,047.13 | $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 $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $645.65 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $147.91 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $691.83 |
Where Virginia sits
The same service costs 4.2 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 $10,315MT $2,461
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.