How much rates vary
Facilitymedian $4,677 · 10th to 90th $589 to $11,220Professionalmedian $603 · 10th to 90th $479 to $955
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 $575.44 Median $6,165.95 Typical High $11,481.54 | Facility | None | $575.44 | $6,165.95 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $3,981.07 | Professional | None | $446.68 | $575.44 | $3,981.07 |
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 $501.19 Median $602.56 Typical High $758.58 | Professional | None | $501.19 | $602.56 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $380.19 Typical High $478.63 | Professional | 62 · Two surgeons | $316.23 | $380.19 | $478.63 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $95.50 Typical High $123.03 | Professional | 80 · Assistant surgeon | $79.43 | $95.50 | $123.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $83.18 Typical High $107.15 | Professional | AS · PA/NP assist | $70.79 | $83.18 | $107.15 |
CareFirst Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $4,786.30 | Professional | None | $524.81 | $575.44 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,344.23 Typical High $4,365.16 | Facility | None | $512.86 | $2,344.23 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $891.25 | Professional | None | $489.78 | $588.84 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $676.08 | Professional | None | $457.09 | $549.54 | $676.08 |
Medcost Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $831.76 | Professional | None | $660.69 | $831.76 | $831.76 |
Medcost Setting Facility Modifier None Typical Low $575.44 Median $691.83 Typical High $933.25 | Facility | None | $575.44 | $691.83 | $933.25 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Sentara Setting Facility Modifier None Typical Low $467.74 Median $1,819.70 Typical High $10,232.93 | Facility | None | $467.74 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $6,025.60 | Professional | None | $524.81 | $676.08 | $6,025.60 |
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 $426.58 Median $660.69 Typical High $1,023.29 | Professional | None | $426.58 | $660.69 | $1,023.29 |
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 $223.87 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $223.87 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $89.13 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $426.58 Typical High $426.58 | Professional | 54 · Surgery only | $338.84 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $67.61 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $44.67 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $398.11 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $316.23 | $398.11 | $398.11 |
Where Virginia sits
The same service costs 5.8 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 $8,906KY $1,548
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.