How much rates vary
Facilitymedian $9,550 · 10th to 90th $380 to $40,738Professionalmedian $347 · 10th to 90th $275 to $490
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 $5,011.87 Typical High $14,791.08 | Facility | None | $812.83 | $5,011.87 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $346.74 Typical High $416.87 | Professional | None | $323.59 | $346.74 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $48,977.88 Median $63,095.73 Typical High $67,608.30 | Facility | None | $48,977.88 | $63,095.73 | $67,608.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $426.58 | Professional | None | $295.12 | $354.81 | $426.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $57.54 Typical High $69.18 | Professional | 80 · Assistant surgeon | $48.98 | $57.54 | $69.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $50.12 Typical High $60.26 | Professional | AS · PA/NP assist | $41.69 | $50.12 | $60.26 |
CareFirst Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $467.74 | Professional | None | $323.59 | $354.81 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $12,882.50 Typical High $26,302.68 | Facility | None | $346.74 | $12,882.50 | $26,302.68 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $478.63 | Professional | None | $275.42 | $316.23 | $478.63 |
Kaiser Permanente Setting Professional Modifier None Typical Low $302.00 Median $363.08 Typical High $457.09 | Professional | None | $302.00 | $363.08 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $398.11 Median $501.19 Typical High $501.19 | Professional | None | $398.11 | $501.19 | $501.19 |
Medcost Setting Facility Modifier None Typical Low $346.74 Median $389.05 Typical High $562.34 | Facility | None | $346.74 | $389.05 | $562.34 |
Medcost Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $371.54 | Professional | None | $288.40 | $338.84 | $371.54 |
Sentara Setting Facility Modifier None Typical Low $288.40 Median $1,412.54 Typical High $30,199.52 | Facility | None | $288.40 | $1,412.54 | $30,199.52 |
Sentara Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $758.58 | Professional | None | $309.03 | $389.05 | $758.58 |
United Setting Facility Modifier None Typical Low $4,570.88 Median $14,454.40 Typical High $47,863.01 | Facility | None | $4,570.88 | $14,454.40 | $47,863.01 |
United Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $562.34 | Professional | None | $208.93 | $275.42 | $562.34 |
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 $162.18 Median $173.78 Typical High $173.78 | Professional | 52 · Reduced service | $162.18 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $66.07 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $34.67 Typical High $34.67 | Professional | 56 · Pre-op care only | $32.36 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $229.09 | $239.88 | $239.88 |
Where Virginia sits
The same service costs 29.1 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 $30,626MT $1,051
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.