How much rates vary
Facilitymedian $4,365 · 10th to 90th $776 to $16,218Professionalmedian $871 · 10th to 90th $661 to $1,585
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 $776.25 Median $3,801.89 Typical High $14,125.38 | Facility | None | $776.25 | $3,801.89 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $2,570.40 | Professional | None | $741.31 | $1,122.02 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,265.80 Median $9,549.93 Typical High $15,848.93 | Facility | None | $4,265.80 | $9,549.93 | $15,848.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,096.48 | Professional | None | $707.95 | $851.14 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,288.25 Typical High $1,621.81 | Professional | 50 · Both sides | $1,071.52 | $1,288.25 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $537.03 Typical High $691.83 | Professional | 62 · Two surgeons | $446.68 | $537.03 | $691.83 |
CareFirst Setting Professional Modifier None Typical Low $741.31 Median $812.83 Typical High $8,511.38 | Professional | None | $741.31 | $812.83 | $8,511.38 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $2,884.03 Typical High $6,025.60 | Facility | None | $478.63 | $2,884.03 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $812.83 Typical High $1,584.89 | Professional | None | $489.78 | $812.83 | $1,584.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,000.00 | Professional | None | $676.08 | $812.83 | $1,000.00 |
Medcost Setting Professional Modifier None Typical Low $549.54 Median $1,000.00 Typical High $1,000.00 | Professional | None | $549.54 | $1,000.00 | $1,000.00 |
Medcost Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $1,819.70 | Facility | None | $524.81 | $524.81 | $1,819.70 |
Medcost Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Sentara Setting Facility Modifier None Typical Low $416.87 Median $2,454.71 Typical High $10,232.93 | Facility | None | $416.87 | $2,454.71 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $467.74 Median $1,148.15 Typical High $7,413.10 | Professional | None | $467.74 | $1,148.15 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $8,511.38 Typical High $26,915.35 | Facility | None | $1,995.26 | $8,511.38 | $26,915.35 |
United Setting Professional Modifier None Typical Low $380.19 Median $954.99 Typical High $1,905.46 | Professional | None | $380.19 | $954.99 | $1,905.46 |
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 $380.19 Median $549.54 Typical High $562.34 | Professional | 52 · Reduced service | $380.19 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $218.78 Typical High $223.87 | Professional | 53 · Discontinued | $151.36 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $575.44 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $114.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $109.65 Typical High $112.20 | Professional | 56 · Pre-op care only | $75.86 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $537.03 | $776.25 | $776.25 |
Where Virginia sits
The same service costs 6.0 times more in Colorado than in Hawaii. 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
CO $12,924HI $2,150
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.