How much rates vary
Facilitymedian $4,074 · 10th to 90th $1,148 to $11,220Professionalmedian $1,862 · 10th to 90th $1,479 to $2,884
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 $1,995.26 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,995.26 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $3,630.78 | Professional | None | $1,819.70 | $1,995.26 | $3,630.78 |
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 $1,479.11 Median $1,778.28 Typical High $2,238.72 | Professional | None | $1,479.11 | $1,778.28 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,691.53 Typical High $3,388.44 | Professional | 50 · Both sides | $2,238.72 | $2,691.53 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $933.25 Median $1,122.02 Typical High $1,412.54 | Professional | 62 · Two surgeons | $933.25 | $1,122.02 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $281.84 Typical High $363.08 | Professional | 80 · Assistant surgeon | $239.88 | $281.84 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $251.19 Typical High $316.23 | Professional | AS · PA/NP assist | $208.93 | $251.19 | $316.23 |
CareFirst Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,238.72 | Professional | None | $1,621.81 | $1,819.70 | $2,238.72 |
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 $1,513.56 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,949.84 | $2,818.38 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,089.30 | Professional | None | $1,412.54 | $1,698.24 | $2,089.30 |
Medcost Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,884.03 | $2,884.03 |
Medcost Setting Facility Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $2,951.21 | Facility | None | $1,819.70 | $2,290.87 | $2,951.21 |
Medcost Setting Professional Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,137.96 | $2,137.96 | $2,137.96 |
Sentara Setting Facility Modifier None Typical Low $1,258.93 Median $2,089.30 Typical High $8,511.38 | Facility | None | $1,258.93 | $2,089.30 | $8,511.38 |
Sentara Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $5,495.41 | Professional | None | $1,412.54 | $2,187.76 | $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 $1,445.44 Median $2,238.72 Typical High $3,388.44 | Professional | None | $1,445.44 | $2,238.72 | $3,388.44 |
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 $912.01 Median $912.01 Typical High $1,000.00 | Professional | 52 · Reduced service | $912.01 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | 53 · Discontinued | $363.08 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,380.38 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,380.38 | $1,380.38 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | 55 · Aftercare only | $275.42 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | 56 · Pre-op care only | $181.97 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,288.25 Typical High $1,380.38 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,288.25 | $1,380.38 |
Where Virginia sits
The same service costs 8.2 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 $19,170WA $2,342
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.