How much rates vary
Facilitymedian $3,981 · 10th to 90th $912 to $10,233Professionalmedian $1,047 · 10th to 90th $871 to $1,660
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 $1,047.13 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,047.13 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $4,365.16 | Professional | None | $977.24 | $1,047.13 | $4,365.16 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $9,549.93 | Facility | None | $6,165.95 | $7,413.10 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,023.29 Typical High $1,318.26 | Professional | None | $870.96 | $1,023.29 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $645.65 Typical High $831.76 | Professional | 62 · Two surgeons | $537.03 | $645.65 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $165.96 Typical High $208.93 | Professional | 80 · Assistant surgeon | $138.04 | $165.96 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $144.54 Typical High $186.21 | Professional | AS · PA/NP assist | $120.23 | $144.54 | $186.21 |
CareFirst Setting Professional Modifier None Typical Low $891.25 Median $1,000.00 Typical High $6,918.31 | Professional | None | $891.25 | $1,000.00 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,818.38 Typical High $5,128.61 | Facility | None | $724.44 | $2,818.38 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,621.81 | Professional | None | $912.01 | $1,071.52 | $1,621.81 |
Kaiser Permanente Setting Professional Modifier None Typical Low $812.83 Median $954.99 Typical High $1,202.26 | Professional | None | $812.83 | $954.99 | $1,202.26 |
Medcost Setting Professional Modifier None Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,202.26 | $1,479.11 | $1,479.11 |
Medcost Setting Facility Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $1,737.80 | Facility | None | $1,047.13 | $1,380.38 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Sentara Setting Facility Modifier None Typical Low $851.14 Median $1,778.28 Typical High $8,709.64 | Facility | None | $851.14 | $1,778.28 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $5,128.61 | Professional | None | $870.96 | $1,230.27 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,862.09 | Professional | None | $758.58 | $1,202.26 | $1,862.09 |
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 $489.78 Median $524.81 Typical High $524.81 | Professional | 52 · Reduced service | $489.78 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 53 · Discontinued | $194.98 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $741.31 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $147.91 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $97.72 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $691.83 | $741.31 | $741.31 |
Where Virginia sits
The same service costs 4.1 times more in Alaska than in Delaware. 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 $9,881DE $2,434
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.