How much rates vary
Facilitymedian $5,495 · 10th to 90th $977 to $15,488Professionalmedian $955 · 10th to 90th $776 to $1,318
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 $954.99 Median $5,370.32 Typical High $14,125.38 | Facility | None | $954.99 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $954.99 Typical High $1,096.48 | Professional | None | $912.01 | $954.99 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,677.35 Median $6,456.54 Typical High $7,244.36 | Facility | None | $4,677.35 | $6,456.54 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,202.26 | Professional | None | $831.76 | $1,000.00 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $630.96 Typical High $758.58 | Professional | 62 · Two surgeons | $524.81 | $630.96 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $158.49 Typical High $190.55 | Professional | 80 · Assistant surgeon | $134.90 | $158.49 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $141.25 Typical High $165.96 | Professional | AS · PA/NP assist | $117.49 | $141.25 | $165.96 |
CareFirst Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,230.27 | Professional | None | $954.99 | $1,047.13 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,715.35 Typical High $7,079.46 | Facility | None | $1,148.15 | $3,715.35 | $7,079.46 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,348.96 | Professional | None | $831.76 | $912.01 | $1,348.96 |
Kaiser Permanente Setting Professional Modifier None Typical Low $831.76 Median $1,000.00 Typical High $1,258.93 | Professional | None | $831.76 | $1,000.00 | $1,258.93 |
Medcost Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,258.93 | $1,258.93 |
Medcost Setting Facility Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,584.89 | Facility | None | $954.99 | $1,047.13 | $1,584.89 |
Medcost Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,047.13 | Professional | None | $933.25 | $1,023.29 | $1,047.13 |
Sentara Setting Facility Modifier None Typical Low $741.31 Median $2,454.71 Typical High $12,589.25 | Facility | None | $741.31 | $2,454.71 | $12,589.25 |
Sentara Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $2,089.30 | Professional | None | $851.14 | $1,047.13 | $2,089.30 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $10,000.00 Typical High $25,118.86 | Facility | None | $2,570.40 | $10,000.00 | $25,118.86 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,584.89 | Professional | None | $575.44 | $776.25 | $1,584.89 |
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 $457.09 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $691.83 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $138.04 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $645.65 | $676.08 | $676.08 |
Where Virginia sits
The same service costs 5.1 times more in Oklahoma than in Kentucky. 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
OK $11,738KY $2,311
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.