How much rates vary
Facilitymedian $4,677 · 10th to 90th $1,230 to $11,220Professionalmedian $1,549 · 10th to 90th $1,230 to $2,570
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 $1,621.81 Median $5,495.41 Typical High $14,125.38 | Facility | None | $1,621.81 | $5,495.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $3,162.28 | Professional | None | $1,513.56 | $1,621.81 | $3,162.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,479.11 Typical High $1,862.09 | Professional | None | $1,230.27 | $1,479.11 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $933.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $776.25 | $933.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $234.42 Typical High $295.12 | Professional | 80 · Assistant surgeon | $194.98 | $234.42 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $169.82 Median $204.17 Typical High $257.04 | Professional | AS · PA/NP assist | $169.82 | $204.17 | $257.04 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,479.11 Typical High $4,677.35 | Professional | None | $1,318.26 | $1,479.11 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $3,090.30 Typical High $6,025.60 | Facility | None | $512.86 | $3,090.30 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,584.89 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,148.15 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,380.38 | $1,698.24 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,737.80 | $2,238.72 | $2,238.72 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,513.56 | $1,819.70 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Sentara Setting Facility Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $10,232.93 | Facility | None | $1,023.29 | $2,290.87 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $8,511.38 | Professional | None | $1,148.15 | $1,778.28 | $8,511.38 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $17,378.01 | Facility | None | $1,548.82 | $6,760.83 | $17,378.01 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,174.90 | $1,819.70 | $2,754.23 |
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 $758.58 Median $758.58 Typical High $812.83 | Professional | 52 · Reduced service | $758.58 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | 53 · Discontinued | $302.00 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,148.15 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,148.15 | $1,148.15 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $229.09 Typical High $245.47 | Professional | 55 · Aftercare only | $229.09 | $229.09 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $151.36 Typical High $162.18 | Professional | 56 · Pre-op care only | $151.36 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,071.52 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,071.52 | $1,148.15 |
Where Virginia sits
The same service costs 6.6 times more in Alabama than in Kentucky. 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 $18,462KY $2,797
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.