How much rates vary
Facilitymedian $14,125 · 10th to 90th $490 to $46,774Professionalmedian $427 · 10th to 90th $355 to $646
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 $426.58 Median $4,365.16 Typical High $10,000.00 | Facility | None | $426.58 | $4,365.16 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $831.76 | Professional | None | $398.11 | $426.58 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $24,547.09 Median $31,622.78 Typical High $34,673.69 | Facility | None | $24,547.09 | $31,622.78 | $34,673.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $524.81 | Professional | None | $363.08 | $436.52 | $524.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $229.09 Median $275.42 Typical High $331.13 | Professional | 62 · Two surgeons | $229.09 | $275.42 | $331.13 |
CareFirst Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $537.03 | Professional | None | $363.08 | $407.38 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $14,454.40 Typical High $29,512.09 | Facility | None | $478.63 | $14,454.40 | $29,512.09 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $660.69 | Professional | None | $354.81 | $389.05 | $660.69 |
Kaiser Permanente Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $537.03 | Professional | None | $354.81 | $426.58 | $537.03 |
Medcost Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $812.83 | Professional | None | $645.65 | $812.83 | $812.83 |
Medcost Setting Facility Modifier None Typical Low $426.58 Median $537.03 Typical High $707.95 | Facility | None | $426.58 | $537.03 | $707.95 |
Medcost Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | None | $426.58 | $501.19 | $562.34 |
Sentara Setting Facility Modifier None Typical Low $398.11 Median $1,737.80 Typical High $40,738.03 | Facility | None | $398.11 | $1,737.80 | $40,738.03 |
Sentara Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $933.25 | Professional | None | $389.05 | $524.81 | $933.25 |
United Setting Facility Modifier None Typical Low $10,000.00 Median $22,908.68 Typical High $64,565.42 | Facility | None | $10,000.00 | $22,908.68 | $64,565.42 |
United Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $758.58 | Professional | None | $269.15 | $380.19 | $758.58 |
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 $199.53 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $199.53 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $79.43 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $275.42 | $302.00 | $302.00 |
Where Virginia sits
The same service costs 29.4 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 $37,066MT $1,262
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.