How much rates vary
Facilitymedian $2,754 · 10th to 90th $537 to $10,233Professionalmedian $2,754 · 10th to 90th $2,188 to $4,266
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 $2,951.21 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,951.21 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,511.89 Median $2,884.03 Typical High $4,786.30 | Professional | None | $2,511.89 | $2,884.03 | $4,786.30 |
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 $2,187.76 Median $2,630.27 Typical High $3,311.31 | Professional | None | $2,187.76 | $2,630.27 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,659.59 Typical High $2,089.30 | Professional | 62 · Two surgeons | $1,380.38 | $1,659.59 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $416.87 Typical High $524.81 | Professional | 80 · Assistant surgeon | $346.74 | $416.87 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $363.08 Typical High $467.74 | Professional | AS · PA/NP assist | $309.03 | $363.08 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $3,467.37 | Professional | None | $2,511.89 | $2,754.23 | $3,467.37 |
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 $2,238.72 Median $2,818.38 Typical High $4,073.80 | Professional | None | $2,238.72 | $2,818.38 | $4,073.80 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $3,162.28 | Professional | None | $2,137.96 | $2,570.40 | $3,162.28 |
Medcost Setting Professional Modifier None Typical Low $2,884.03 Median $3,630.78 Typical High $3,630.78 | Professional | None | $2,884.03 | $3,630.78 | $3,630.78 |
Medcost Setting Facility Modifier None Typical Low $2,691.53 Median $3,388.44 Typical High $4,365.16 | Facility | None | $2,691.53 | $3,388.44 | $4,365.16 |
Medcost Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Professional | None | $3,162.28 | $3,162.28 | $3,162.28 |
Sentara Setting Facility Modifier None Typical Low $1,513.56 Median $2,570.40 Typical High $8,912.51 | Facility | None | $1,513.56 | $2,570.40 | $8,912.51 |
Sentara Setting Professional Modifier None Typical Low $1,949.84 Median $3,090.30 Typical High $6,165.95 | Professional | None | $1,949.84 | $3,090.30 | $6,165.95 |
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 $2,089.30 Median $3,235.94 Typical High $4,897.79 | Professional | None | $2,089.30 | $3,235.94 | $4,897.79 |
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 $1,348.96 Median $1,348.96 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,348.96 | $1,348.96 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | 53 · Discontinued | $537.03 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $1,995.26 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,995.26 | $1,995.26 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $407.38 Typical High $436.52 | Professional | 55 · Aftercare only | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | 56 · Pre-op care only | $269.15 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,862.09 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,862.09 | $2,041.74 |
Where Virginia sits
The same service costs 7.2 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 $21,573WA $2,995
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.