How much rates vary
Facilitymedian $2,512 · 10th to 90th $550 to $10,233Professionalmedian $2,239 · 10th to 90th $1,778 to $3,388
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 $2,398.83 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,398.83 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $3,890.45 | Professional | None | $2,089.30 | $2,344.23 | $3,890.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,964.78 Median $13,803.84 Typical High $15,848.93 | Facility | None | $10,964.78 | $13,803.84 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,691.53 | Professional | None | $1,778.28 | $2,089.30 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $338.84 Typical High $426.58 | Professional | 80 · Assistant surgeon | $281.84 | $338.84 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $295.12 Typical High $371.54 | Professional | AS · PA/NP assist | $245.47 | $295.12 | $371.54 |
CareFirst Setting Professional Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,818.38 | Professional | None | $1,995.26 | $2,238.72 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $2,398.83 Typical High $3,311.31 | Professional | None | $1,778.28 | $2,398.83 | $3,311.31 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,698.24 Median $2,041.74 Typical High $2,511.89 | Professional | None | $1,698.24 | $2,041.74 | $2,511.89 |
Medcost Setting Facility Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $3,548.13 | Facility | None | $2,187.76 | $2,630.27 | $3,548.13 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Sentara Setting Facility Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $7,413.10 | Facility | None | $1,380.38 | $2,238.72 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $2,570.40 Typical High $5,495.41 | Professional | None | $1,862.09 | $2,570.40 | $5,495.41 |
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 $1,737.80 Median $2,818.38 Typical High $4,265.80 | Professional | None | $1,737.80 | $2,818.38 | $4,265.80 |
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 $1,096.48 Median $1,096.48 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,096.48 | $1,096.48 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | 53 · Discontinued | $436.52 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,621.81 Median $1,621.81 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,621.81 | $1,621.81 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $323.59 Typical High $354.81 | Professional | 55 · Aftercare only | $323.59 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | 56 · Pre-op care only | $218.78 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,513.56 | $1,513.56 | $1,659.59 |
Where Virginia sits
The same service costs 8.0 times more in Alabama than in Washington. 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 $20,353WA $2,540
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.