How much rates vary
Facilitymedian $2,291 · 10th to 90th $537 to $10,000Professionalmedian $1,622 · 10th to 90th $1,288 to $2,455
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 $1,737.80 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,737.80 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,479.11 | $1,548.82 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $11,220.18 Typical High $17,378.01 | Facility | None | $8,912.51 | $11,220.18 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,288.25 | $1,548.82 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $977.24 Typical High $1,230.27 | Professional | 62 · Two surgeons | $812.83 | $977.24 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $245.47 Typical High $309.03 | Professional | 80 · Assistant surgeon | $204.17 | $245.47 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $213.80 Typical High $275.42 | Professional | AS · PA/NP assist | $181.97 | $213.80 | $275.42 |
CareFirst Setting Professional Modifier None Typical Low $1,380.38 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,380.38 | $1,548.82 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,174.90 Typical High $5,495.41 | Facility | None | $501.19 | $1,174.90 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,698.24 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,513.56 | $1,862.09 |
Medcost Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $2,187.76 | Professional | None | $1,778.28 | $2,187.76 | $2,187.76 |
Medcost Setting Facility Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,570.40 | Facility | None | $1,548.82 | $1,949.84 | $2,570.40 |
Medcost Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,819.70 | $1,819.70 | $1,819.70 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $6,309.57 | Facility | None | $1,023.29 | $1,905.46 | $6,309.57 |
Sentara Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $5,128.61 | Professional | None | $1,288.25 | $1,862.09 | $5,128.61 |
United Setting Facility Modifier None Typical Low $436.52 Median $2,344.23 Typical High $6,309.57 | Facility | None | $436.52 | $2,344.23 | $6,309.57 |
United Setting Professional Modifier None Typical Low $1,230.27 Median $1,862.09 Typical High $2,884.03 | Professional | None | $1,230.27 | $1,862.09 | $2,884.03 |
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 $776.25 Median $776.25 Typical High $851.14 | Professional | 52 · Reduced service | $776.25 | $776.25 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | 53 · Discontinued | $309.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $257.04 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 56 · Pre-op care only | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,202.26 |
Where Virginia sits
The same service costs 8.9 times more in Alabama than in Maryland. 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 $18,845MD $2,111
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.