How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,148 to $11,220Professionalmedian $2,344 · 10th to 90th $1,862 to $3,715
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 $2,630.27 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,630.27 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,570.40 Typical High $4,365.16 | Professional | None | $2,344.23 | $2,570.40 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,818.38 Median $7,413.10 Typical High $12,589.25 | Facility | None | $2,818.38 | $7,413.10 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $2,951.21 | Professional | None | $1,949.84 | $2,344.23 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,884.03 Median $3,467.37 Typical High $4,365.16 | Professional | 50 · Both sides | $2,884.03 | $3,467.37 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,445.44 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,230.27 | $1,445.44 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $371.54 Typical High $467.74 | Professional | 80 · Assistant surgeon | $309.03 | $371.54 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $323.59 Typical High $407.38 | Professional | AS · PA/NP assist | $269.15 | $323.59 | $407.38 |
CareFirst Setting Professional Modifier None Typical Low $2,089.30 Median $2,344.23 Typical High $2,884.03 | Professional | None | $2,089.30 | $2,344.23 | $2,884.03 |
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 $1,862.09 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,862.09 | $2,344.23 | $3,548.13 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,187.76 | $2,691.53 |
Medcost Setting Professional Modifier None Typical Low $1,584.89 Median $2,754.23 Typical High $2,754.23 | Professional | None | $1,584.89 | $2,754.23 | $2,754.23 |
Medcost Setting Facility Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $3,801.89 | Facility | None | $2,344.23 | $2,691.53 | $3,801.89 |
Medcost Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Sentara Setting Facility Modifier None Typical Low $1,174.90 Median $2,344.23 Typical High $9,332.54 | Facility | None | $1,174.90 | $2,344.23 | $9,332.54 |
Sentara Setting Professional Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $5,623.41 | Professional | None | $1,412.54 | $2,630.27 | $5,623.41 |
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 $1,548.82 Median $2,691.53 Typical High $4,168.69 | Professional | None | $1,548.82 | $2,691.53 | $4,168.69 |
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 $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 53 · Discontinued | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $389.05 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,819.70 |
Where Virginia sits
The same service costs 7.2 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 $19,737WA $2,745
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.