How much rates vary
Facilitymedian $3,715 · 10th to 90th $708 to $10,000Professionalmedian $724 · 10th to 90th $589 to $1,148
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 $707.95 Median $4,786.30 Typical High $10,000.00 | Facility | None | $707.95 | $4,786.30 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $676.08 Median $707.95 Typical High $3,467.37 | Professional | None | $676.08 | $707.95 | $3,467.37 |
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 $588.84 Median $707.95 Typical High $912.01 | Professional | None | $588.84 | $707.95 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $446.68 Typical High $575.44 | Professional | 62 · Two surgeons | $371.54 | $446.68 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $112.20 Typical High $144.54 | Professional | 80 · Assistant surgeon | $95.50 | $112.20 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $100.00 Typical High $125.89 | Professional | AS · PA/NP assist | $83.18 | $100.00 | $125.89 |
CareFirst Setting Professional Modifier None Typical Low $616.60 Median $691.83 Typical High $5,495.41 | Professional | None | $616.60 | $691.83 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,454.71 Typical High $5,128.61 | Facility | None | $478.63 | $2,454.71 | $5,128.61 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,096.48 | Professional | None | $616.60 | $724.44 | $1,096.48 |
Kaiser Permanente Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $831.76 | Professional | None | $562.34 | $660.69 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | None | $812.83 | $1,023.29 | $1,023.29 |
Medcost Setting Facility Modifier None Typical Low $707.95 Median $933.25 Typical High $1,174.90 | Facility | None | $707.95 | $933.25 | $1,174.90 |
Medcost Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Sentara Setting Facility Modifier None Typical Low $588.84 Median $1,737.80 Typical High $8,709.64 | Facility | None | $588.84 | $1,737.80 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $4,073.80 | Professional | None | $616.60 | $831.76 | $4,073.80 |
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 $524.81 Median $831.76 Typical High $1,288.25 | Professional | None | $524.81 | $831.76 | $1,288.25 |
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 $338.84 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $501.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $501.19 |
Where Virginia sits
The same service costs 4.4 times more in Alabama than in Montana. 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 $8,633MT $1,977
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.