How much rates vary
Facilitymedian $741 · 10th to 90th $174 to $4,786Professionalmedian $275 · 10th to 90th $219 to $389
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 $281.84 Median $4,073.80 Typical High $10,000.00 | Facility | None | $281.84 | $4,073.80 | $10,000.00 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $281.84 Typical High $331.13 | Professional | None | $245.47 | $281.84 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $331.13 | Professional | None | $229.09 | $275.42 | $331.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $144.54 Median $173.78 Typical High $208.93 | Professional | 62 · Two surgeons | $144.54 | $173.78 | $208.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $43.65 Typical High $52.48 | Professional | 80 · Assistant surgeon | $37.15 | $43.65 | $52.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $38.02 Typical High $45.71 | Professional | AS · PA/NP assist | $31.62 | $38.02 | $45.71 |
CareFirst Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $346.74 | Professional | None | $239.88 | $263.03 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $676.08 Typical High $2,691.53 | Facility | None | $346.74 | $676.08 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $389.05 | Professional | None | $223.87 | $245.47 | $389.05 |
Kaiser Permanente Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $302.00 | Professional | None | $204.17 | $245.47 | $302.00 |
Medcost Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | None | $371.54 | $467.74 | $467.74 |
Medcost Setting Facility Modifier None Typical Low $281.84 Median $346.74 Typical High $457.09 | Facility | None | $281.84 | $346.74 | $457.09 |
Medcost Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $549.54 | Professional | None | $323.59 | $380.19 | $549.54 |
Sentara Setting Facility Modifier None Typical Low $239.88 Median $436.52 Typical High $2,454.71 | Facility | None | $239.88 | $436.52 | $2,454.71 |
Sentara Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $602.56 | Professional | None | $251.19 | $331.13 | $602.56 |
United Setting Facility Modifier None Typical Low $100.00 Median $660.69 Typical High $2,089.30 | Facility | None | $100.00 | $660.69 | $2,089.30 |
United Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $457.09 | Professional | None | $165.96 | $239.88 | $457.09 |
5 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 $123.03 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $123.03 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $50.12 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 54 · Surgery only | $186.21 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $37.15 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $24.55 | $28.18 | $28.18 |
Where Virginia sits
The same service costs 17.5 times more in Alabama than in Delaware. 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 $7,281DE $415
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.