How much rates vary
Facilitymedian $4,571 · 10th to 90th $851 to $17,378Professionalmedian $851 · 10th to 90th $676 to $1,349
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 $812.83 Median $4,365.16 Typical High $11,481.54 | Facility | None | $812.83 | $4,365.16 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,905.46 | Professional | None | $616.60 | $812.83 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,413.10 Median $14,791.08 Typical High $21,379.62 | Facility | None | $7,413.10 | $14,791.08 | $21,379.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,071.52 | Professional | None | $691.83 | $831.76 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $524.81 Typical High $676.08 | Professional | 62 · Two surgeons | $436.52 | $524.81 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $134.90 Typical High $169.82 | Professional | 80 · Assistant surgeon | $112.20 | $134.90 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $117.49 Typical High $151.36 | Professional | AS · PA/NP assist | $97.72 | $117.49 | $151.36 |
CareFirst Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $6,918.31 | Professional | None | $724.44 | $812.83 | $6,918.31 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,019.95 Typical High $5,623.41 | Facility | None | $707.95 | $3,019.95 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,258.93 | Professional | None | $691.83 | $831.76 | $1,258.93 |
Kaiser Permanente Setting Professional Modifier None Typical Low $645.65 Median $758.58 Typical High $954.99 | Professional | None | $645.65 | $758.58 | $954.99 |
Medcost Setting Professional Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,288.25 | $1,288.25 |
Medcost Setting Facility Modifier None Typical Low $812.83 Median $1,000.00 Typical High $1,318.26 | Facility | None | $812.83 | $1,000.00 | $1,318.26 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | None | $933.25 | $933.25 | $933.25 |
Sentara Setting Facility Modifier None Typical Low $676.08 Median $2,137.96 Typical High $10,232.93 | Facility | None | $676.08 | $2,137.96 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $7,413.10 | Professional | None | $741.31 | $977.24 | $7,413.10 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $8,511.38 Typical High $22,387.21 | Facility | None | $2,137.96 | $8,511.38 | $22,387.21 |
United Setting Professional Modifier None Typical Low $602.56 Median $977.24 Typical High $1,445.44 | Professional | None | $602.56 | $977.24 | $1,445.44 |
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 $309.03 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $309.03 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $123.03 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $467.74 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $93.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $61.66 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $436.52 | $562.34 | $562.34 |
Where Virginia sits
The same service costs 4.5 times more in Alaska 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
AK $10,099MT $2,245
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.