How much rates vary
Facilitymedian $2,138 · 10th to 90th $490 to $6,607Professionalmedian $550 · 10th to 90th $437 to $891
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 $575.44 Median $5,495.41 Typical High $14,125.38 | Facility | None | $575.44 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $1,122.02 | Professional | None | $537.03 | $575.44 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $4,265.80 | Facility | None | $2,884.03 | $3,715.35 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $660.69 | Professional | None | $436.52 | $524.81 | $660.69 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $69.18 Median $83.18 Typical High $104.71 | Professional | 80 · Assistant surgeon | $69.18 | $83.18 | $104.71 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $72.44 Typical High $91.20 | Professional | AS · PA/NP assist | $60.26 | $72.44 | $91.20 |
CareFirst Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $630.96 | Professional | None | $457.09 | $512.86 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $794.33 Typical High $5,495.41 | Facility | None | $501.19 | $794.33 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $602.56 Typical High $831.76 | Professional | None | $436.52 | $602.56 | $831.76 |
Kaiser Permanente Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $602.56 | Professional | None | $407.38 | $489.78 | $602.56 |
Medcost Setting Facility Modifier None Typical Low $537.03 Median $645.65 Typical High $891.25 | Facility | None | $537.03 | $645.65 | $891.25 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
Sentara Setting Facility Modifier None Typical Low $478.63 Median $1,174.90 Typical High $5,128.61 | Facility | None | $478.63 | $1,174.90 | $5,128.61 |
Sentara Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $2,454.71 | Professional | None | $489.78 | $645.65 | $2,454.71 |
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 $426.58 Median $707.95 Typical High $1,071.52 | Professional | None | $426.58 | $707.95 | $1,071.52 |
5 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 $269.15 Median $269.15 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $107.15 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $436.52 | Professional | 54 · Surgery only | $407.38 | $407.38 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $57.54 |
Where Virginia sits
The same service costs 5.7 times more in Alaska 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
AK $6,128MD $1,075
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.