How much rates vary
Facilitymedian $4,365 · 10th to 90th $661 to $10,965Professionalmedian $631 · 10th to 90th $513 to $891
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 $630.96 Median $5,623.41 Typical High $10,964.78 | Facility | None | $630.96 | $5,623.41 | $10,964.78 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $891.25 | Professional | None | $602.56 | $630.96 | $891.25 |
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 $537.03 Median $645.65 Typical High $776.25 | Professional | None | $537.03 | $645.65 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $954.99 Typical High $1,148.15 | Professional | 50 · Both sides | $812.83 | $954.99 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $407.38 Typical High $489.78 | Professional | 62 · Two surgeons | $338.84 | $407.38 | $489.78 |
CareFirst Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $812.83 | Professional | None | $562.34 | $630.96 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,698.24 Typical High $3,235.94 | Facility | None | $645.65 | $1,698.24 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $891.25 | Professional | None | $537.03 | $575.44 | $891.25 |
Kaiser Permanente Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $794.33 | Professional | None | $524.81 | $630.96 | $794.33 |
Medcost Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $933.25 | Professional | None | $758.58 | $933.25 | $933.25 |
Medcost Setting Facility Modifier None Typical Low $630.96 Median $741.31 Typical High $1,047.13 | Facility | None | $630.96 | $741.31 | $1,047.13 |
Medcost Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $851.14 | Professional | None | $691.83 | $794.33 | $851.14 |
Sentara Setting Facility Modifier None Typical Low $524.81 Median $1,819.70 Typical High $10,232.93 | Facility | None | $524.81 | $1,819.70 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,348.96 | Professional | None | $575.44 | $676.08 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,595.87 | Facility | None | $1,548.82 | $6,760.83 | $16,595.87 |
United Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $1,023.29 | Professional | None | $398.11 | $524.81 | $1,023.29 |
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 $302.00 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $302.00 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $120.23 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $446.68 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $89.13 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $416.87 | $446.68 | $446.68 |
Where Virginia sits
The same service costs 4.1 times more in Wisconsin 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
WI $7,505MT $1,845
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.