How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,230 to $9,772Professionalmedian $1,514 · 10th to 90th $1,259 to $2,399
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 $1,513.56 Median $5,370.32 Typical High $14,125.38 | Facility | None | $1,513.56 | $5,370.32 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,348.96 Median $1,513.56 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,513.56 | $3,388.44 |
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 $1,258.93 Median $1,479.11 Typical High $1,905.46 | Professional | None | $1,258.93 | $1,479.11 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $239.88 Typical High $302.00 | Professional | 80 · Assistant surgeon | $199.53 | $239.88 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $208.93 Typical High $269.15 | Professional | AS · PA/NP assist | $173.78 | $208.93 | $269.15 |
CareFirst Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $5,495.41 | Professional | None | $1,318.26 | $1,445.44 | $5,495.41 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $3,548.13 | Facility | None | $707.95 | $1,445.44 | $3,548.13 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,398.83 | Professional | None | $1,288.25 | $1,513.56 | $2,398.83 |
Kaiser Permanente Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,412.54 | $1,737.80 |
Medcost Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,737.80 | $2,290.87 | $2,290.87 |
Medcost Setting Facility Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,454.71 | Facility | None | $1,513.56 | $1,819.70 | $2,454.71 |
Medcost Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Sentara Setting Facility Modifier None Typical Low $1,071.52 Median $2,089.30 Typical High $8,709.64 | Facility | None | $1,071.52 | $2,089.30 | $8,709.64 |
Sentara Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $5,370.32 | Professional | None | $1,318.26 | $1,737.80 | $5,370.32 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $5,011.87 Typical High $13,182.57 | Facility | None | $1,230.27 | $5,011.87 | $13,182.57 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,096.48 | $1,778.28 | $2,691.53 |
2 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 54 · Surgery only Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | 54 · Surgery only | $1,023.29 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,047.13 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $954.99 | $1,047.13 | $1,047.13 |
Where Virginia sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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
WI $9,889MD $2,794
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.