How much rates vary
Facilitymedian $2,512 · 10th to 90th $550 to $10,233Professionalmedian $2,188 · 10th to 90th $1,738 to $3,467
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 $2,290.87 Median $4,786.30 Typical High $14,125.38 | Facility | None | $2,290.87 | $4,786.30 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $4,073.80 | Professional | None | $2,089.30 | $2,290.87 | $4,073.80 |
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 $1,737.80 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,737.80 | $2,041.74 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $275.42 Median $331.13 Typical High $416.87 | Professional | 80 · Assistant surgeon | $275.42 | $331.13 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $288.40 Typical High $363.08 | Professional | AS · PA/NP assist | $239.88 | $288.40 | $363.08 |
CareFirst Setting Professional Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,187.76 | $2,691.53 |
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 $1,737.80 Median $2,290.87 Typical High $3,235.94 | Professional | None | $1,737.80 | $2,290.87 | $3,235.94 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,659.59 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,659.59 | $1,995.26 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,630.27 | $3,311.31 | $3,311.31 |
Medcost Setting Facility Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $3,467.37 | Facility | None | $2,089.30 | $2,691.53 | $3,467.37 |
Medcost Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Sentara Setting Facility Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $7,413.10 | Facility | None | $1,288.25 | $2,238.72 | $7,413.10 |
Sentara Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $5,495.41 | Professional | None | $1,778.28 | $2,454.71 | $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 $1,659.59 Median $2,691.53 Typical High $3,981.07 | Professional | None | $1,659.59 | $2,691.53 | $3,981.07 |
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 $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,047.13 | $1,047.13 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $426.58 Typical High $457.09 | Professional | 53 · Discontinued | $426.58 | $426.58 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,584.89 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,584.89 | $1,584.89 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $316.23 Typical High $346.74 | Professional | 55 · Aftercare only | $316.23 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | 56 · Pre-op care only | $208.93 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,479.11 | $1,621.81 |
Where Virginia sits
The same service costs 12.4 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 $34,135MD $2,750
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.