How much rates vary
Facilitymedian $2,884 · 10th to 90th $537 to $10,233Professionalmedian $2,951 · 10th to 90th $2,344 to $4,365
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 $3,162.28 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,162.28 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $3,981.07 | Professional | None | $2,884.03 | $3,019.95 | $3,981.07 |
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 $2,344.23 Median $2,818.38 Typical High $3,548.13 | Professional | None | $2,344.23 | $2,818.38 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,479.11 Median $1,737.80 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,479.11 | $1,737.80 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $371.54 Median $446.68 Typical High $562.34 | Professional | 80 · Assistant surgeon | $371.54 | $446.68 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $323.59 Median $389.05 Typical High $489.78 | Professional | AS · PA/NP assist | $323.59 | $389.05 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $2,630.27 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,630.27 | $2,951.21 | $3,715.35 |
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 $2,344.23 Median $2,951.21 Typical High $4,365.16 | Professional | None | $2,344.23 | $2,951.21 | $4,365.16 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,238.72 Median $2,691.53 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,691.53 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,818.38 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,818.38 | $3,467.37 | $3,467.37 |
Medcost Setting Facility Modifier None Typical Low $2,884.03 Median $3,548.13 Typical High $4,677.35 | Facility | None | $2,884.03 | $3,548.13 | $4,677.35 |
Medcost Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
Sentara Setting Facility Modifier None Typical Low $1,584.89 Median $2,630.27 Typical High $9,549.93 | Facility | None | $1,584.89 | $2,630.27 | $9,549.93 |
Sentara Setting Professional Modifier None Typical Low $1,905.46 Median $3,235.94 Typical High $6,606.93 | Professional | None | $1,905.46 | $3,235.94 | $6,606.93 |
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 $2,238.72 Median $3,388.44 Typical High $5,248.07 | Professional | None | $2,238.72 | $3,388.44 | $5,248.07 |
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 $1,445.44 Median $1,445.44 Typical High $1,548.82 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,548.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $630.96 | Professional | 53 · Discontinued | $575.44 | $575.44 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,344.23 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,344.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $2,187.76 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $2,187.76 |
Where Virginia sits
The same service costs 7.1 times more in Alaska 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
AK $22,023WA $3,113
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.