How much rates vary
Facilitymedian $2,754 · 10th to 90th $537 to $10,233Professionalmedian $2,818 · 10th to 90th $2,239 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 $3,019.95 Median $5,495.41 Typical High $14,125.38 | Facility | None | $3,019.95 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,951.21 Typical High $4,365.16 | Professional | None | $2,754.23 | $2,951.21 | $4,365.16 |
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 $2,238.72 Median $2,691.53 Typical High $3,388.44 | Professional | None | $2,238.72 | $2,691.53 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,698.24 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,412.54 | $1,698.24 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $426.58 Typical High $537.03 | Professional | 80 · Assistant surgeon | $354.81 | $426.58 | $537.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $371.54 Typical High $467.74 | Professional | AS · PA/NP assist | $316.23 | $371.54 | $467.74 |
CareFirst Setting Professional Modifier None Typical Low $2,570.40 Median $2,818.38 Typical High $3,548.13 | Professional | None | $2,570.40 | $2,818.38 | $3,548.13 |
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 $4,168.69 | Professional | None | $2,238.72 | $2,818.38 | $4,168.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $2,137.96 Median $2,570.40 Typical High $3,235.94 | Professional | None | $2,137.96 | $2,570.40 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,344.23 | $3,019.95 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $2,754.23 Median $3,311.31 Typical High $4,466.84 | Facility | None | $2,754.23 | $3,311.31 | $4,466.84 |
Medcost Setting Professional Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,235.94 | $3,235.94 | $3,235.94 |
Sentara Setting Facility Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $9,120.11 | Facility | None | $1,513.56 | $2,511.89 | $9,120.11 |
Sentara Setting Professional Modifier None Typical Low $1,862.09 Median $3,162.28 Typical High $6,309.57 | Professional | None | $1,862.09 | $3,162.28 | $6,309.57 |
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 $2,041.74 Median $3,311.31 Typical High $5,011.87 | Professional | None | $2,041.74 | $3,311.31 | $5,011.87 |
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 $1,380.38 Median $1,380.38 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $549.54 Typical High $602.56 | Professional | 53 · Discontinued | $549.54 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,089.30 Typical High $2,238.72 | Professional | 54 · Surgery only | $2,089.30 | $2,089.30 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $446.68 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $1,949.84 Typical High $2,089.30 | Professional | 78 · Unplanned return to OR | $1,949.84 | $1,949.84 | $2,089.30 |
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 $21,795WA $3,065
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.