How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,047 to $10,233Professionalmedian $1,230 · 10th to 90th $1,000 to $1,905
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 $1,288.25 Median $5,888.44 Typical High $14,125.38 | Facility | None | $1,288.25 | $5,888.44 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $3,981.07 | Professional | None | $1,202.26 | $1,202.26 | $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 $1,000.00 Median $1,202.26 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,202.26 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $630.96 Median $758.58 Typical High $977.24 | Professional | 62 · Two surgeons | $630.96 | $758.58 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $190.55 Typical High $245.47 | Professional | 80 · Assistant surgeon | $162.18 | $190.55 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $169.82 Typical High $213.80 | Professional | AS · PA/NP assist | $141.25 | $169.82 | $213.80 |
CareFirst Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $5,495.41 | Professional | None | $1,096.48 | $1,230.27 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,019.95 Typical High $5,754.40 | Facility | None | $645.65 | $3,019.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,258.93 Typical High $1,862.09 | Professional | None | $1,047.13 | $1,258.93 | $1,862.09 |
Kaiser Permanente Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $1,318.26 | Professional | None | $891.25 | $1,047.13 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $1,479.11 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,479.11 | $1,819.70 | $1,819.70 |
Medcost Setting Facility Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,995.26 | Facility | None | $1,202.26 | $1,479.11 | $1,995.26 |
Medcost Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
Sentara Setting Facility Modifier None Typical Low $933.25 Median $1,819.70 Typical High $8,709.64 | Facility | None | $933.25 | $1,819.70 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $5,128.61 | Professional | None | $1,071.52 | $1,412.54 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $870.96 Median $1,445.44 Typical High $2,137.96 | Professional | None | $870.96 | $1,445.44 | $2,137.96 |
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 $588.84 Median $602.56 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $602.56 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $239.88 Typical High $257.04 | Professional | 53 · Discontinued | $234.42 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $912.01 Typical High $954.99 | Professional | 54 · Surgery only | $870.96 | $912.01 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $190.55 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $120.23 Typical High $128.82 | Professional | 56 · Pre-op care only | $117.49 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $851.14 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $812.83 | $851.14 | $891.25 |
Where Virginia sits
The same service costs 4.6 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 $11,283KY $2,440
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.