How much rates vary
Facilitymedian $2,512 · 10th to 90th $537 to $10,233Professionalmedian $2,138 · 10th to 90th $1,698 to $3,311
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 $5,495.41 Typical High $14,125.38 | Facility | None | $2,290.87 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $4,265.80 | Professional | None | $1,995.26 | $2,290.87 | $4,265.80 |
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 $1,698.24 Median $2,041.74 Typical High $2,570.40 | Professional | None | $1,698.24 | $2,041.74 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,288.25 Typical High $1,621.81 | Professional | 62 · Two surgeons | $1,071.52 | $1,288.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $323.59 Typical High $407.38 | Professional | 80 · Assistant surgeon | $269.15 | $323.59 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $239.88 Median $281.84 Typical High $354.81 | Professional | AS · PA/NP assist | $239.88 | $281.84 | $354.81 |
CareFirst Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $2,691.53 | Professional | None | $1,949.84 | $2,137.96 | $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 $3,162.28 | Professional | None | $1,737.80 | $2,290.87 | $3,162.28 |
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 $2,570.40 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,570.40 | $3,235.94 | $3,235.94 |
Medcost Setting Facility Modifier None Typical Low $2,089.30 Median $2,570.40 Typical High $3,388.44 | Facility | None | $2,089.30 | $2,570.40 | $3,388.44 |
Medcost Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
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 $1,621.81 Median $2,570.40 Typical High $3,890.45 | Professional | None | $1,621.81 | $2,570.40 | $3,890.45 |
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 $1,023.29 Median $1,023.29 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,023.29 | $1,023.29 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $416.87 Typical High $457.09 | Professional | 53 · Discontinued | $416.87 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,548.82 Median $1,548.82 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,548.82 | $1,548.82 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | 55 · Aftercare only | $309.03 | $309.03 | $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 $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,445.44 | $1,445.44 | $1,584.89 |
Where Virginia sits
The same service costs 7.9 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 $20,238WA $2,549
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.