How much rates vary
Facilitymedian $16,596 · 10th to 90th $1,072 to $117,490Professionalmedian $1,047 · 10th to 90th $851 to $1,995
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 $1,148.15 Median $7,079.46 Typical High $33,884.42 | Facility | None | $1,148.15 | $7,079.46 | $33,884.42 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,288.25 Typical High $7,079.46 | Professional | None | $1,047.13 | $1,288.25 | $7,079.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $123,026.88 Median $154,881.66 Typical High $169,824.37 | Facility | None | $123,026.88 | $154,881.66 | $169,824.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,258.93 | Professional | None | $831.76 | $1,000.00 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $630.96 Typical High $794.33 | Professional | 62 · Two surgeons | $524.81 | $630.96 | $794.33 |
CareFirst Setting Professional Modifier None Typical Low $851.14 Median $954.99 Typical High $15,488.17 | Professional | None | $851.14 | $954.99 | $15,488.17 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $24,547.09 Typical High $46,773.51 | Facility | None | $512.86 | $24,547.09 | $46,773.51 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,584.89 | Professional | None | $851.14 | $1,122.02 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,122.02 | Professional | None | $758.58 | $912.01 | $1,122.02 |
Medcost Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,174.90 | $1,445.44 | $1,445.44 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,698.24 | Facility | None | $1,047.13 | $1,318.26 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $2,454.71 Typical High $51,286.14 | Facility | None | $851.14 | $2,454.71 | $51,286.14 |
Sentara Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $11,481.54 | Professional | None | $851.14 | $1,230.27 | $11,481.54 |
United Setting Facility Modifier None Typical Low $16,982.44 Median $38,018.94 Typical High $125,892.54 | Facility | None | $16,982.44 | $38,018.94 | $125,892.54 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,995.26 | Professional | None | $812.83 | $1,258.93 | $1,995.26 |
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 $524.81 Median $524.81 Typical High $575.44 | Professional | 52 · Reduced service | $524.81 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | 53 · Discontinued | $208.93 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | 54 · Surgery only | $776.25 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $794.33 |
Where Virginia sits
The same service costs 19.9 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 $53,750MT $2,699
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.