How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,148 to $11,220Professionalmedian $1,995 · 10th to 90th $1,585 to $3,162
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 $2,187.76 Median $5,495.41 Typical High $14,125.38 | Facility | None | $2,187.76 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,949.84 Median $2,137.96 Typical High $3,890.45 | Professional | None | $1,949.84 | $2,137.96 | $3,890.45 |
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 $1,584.89 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,905.46 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $2,884.03 Typical High $3,630.78 | Professional | 50 · Both sides | $2,398.83 | $2,884.03 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,000.00 Median $1,202.26 Typical High $1,513.56 | Professional | 62 · Two surgeons | $1,000.00 | $1,202.26 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $309.03 Typical High $389.05 | Professional | 80 · Assistant surgeon | $257.04 | $309.03 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $269.15 Typical High $338.84 | Professional | AS · PA/NP assist | $223.87 | $269.15 | $338.84 |
CareFirst Setting Professional Modifier None Typical Low $1,737.80 Median $1,905.46 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,905.46 | $2,398.83 |
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 $1,621.81 Median $2,089.30 Typical High $3,019.95 | Professional | None | $1,621.81 | $2,089.30 | $3,019.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $2,187.76 | Professional | None | $1,479.11 | $1,778.28 | $2,187.76 |
Medcost Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,290.87 | $3,019.95 | $3,019.95 |
Medcost Setting Facility Modifier None Typical Low $1,949.84 Median $2,398.83 Typical High $3,235.94 | Facility | None | $1,949.84 | $2,398.83 | $3,235.94 |
Medcost Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Professional | None | $2,238.72 | $2,238.72 | $2,238.72 |
Sentara Setting Facility Modifier None Typical Low $1,258.93 Median $2,137.96 Typical High $8,912.51 | Facility | None | $1,258.93 | $2,137.96 | $8,912.51 |
Sentara Setting Professional Modifier None Typical Low $1,348.96 Median $2,238.72 Typical High $5,495.41 | Professional | None | $1,348.96 | $2,238.72 | $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 $1,548.82 Median $2,398.83 Typical High $3,548.13 | Professional | None | $1,548.82 | $2,398.83 | $3,548.13 |
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 $977.24 Median $977.24 Typical High $1,071.52 | Professional | 52 · Reduced service | $977.24 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $389.05 Typical High $436.52 | Professional | 53 · Discontinued | $389.05 | $389.05 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $194.98 Typical High $218.78 | Professional | 56 · Pre-op care only | $194.98 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,513.56 |
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 $19,273WA $2,428
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.