How much rates vary
Facilitymedian $4,677 · 10th to 90th $575 to $12,303Professionalmedian $513 · 10th to 90th $407 to $724
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 $512.86 Median $7,762.47 Typical High $15,488.17 | Facility | None | $512.86 | $7,762.47 | $15,488.17 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $707.95 | Professional | None | $489.78 | $512.86 | $707.95 |
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 $436.52 Median $524.81 Typical High $630.96 | Professional | None | $436.52 | $524.81 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $794.33 Typical High $954.99 | Professional | 50 · Both sides | $660.69 | $794.33 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $331.13 Typical High $398.11 | Professional | 62 · Two surgeons | $275.42 | $331.13 | $398.11 |
CareFirst Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $676.08 | Professional | None | $467.74 | $512.86 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $3,630.78 | Facility | None | $1,000.00 | $1,995.26 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $707.95 | Professional | None | $426.58 | $467.74 | $707.95 |
Kaiser Permanente Setting Professional Modifier None Typical Low $426.58 Median $512.86 Typical High $645.65 | Professional | None | $426.58 | $512.86 | $645.65 |
Medcost Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | None | $602.56 | $758.58 | $758.58 |
Medcost Setting Facility Modifier None Typical Low $512.86 Median $575.44 Typical High $831.76 | Facility | None | $512.86 | $575.44 | $831.76 |
Medcost Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $724.44 | Professional | None | $537.03 | $660.69 | $724.44 |
Sentara Setting Facility Modifier None Typical Low $426.58 Median $1,737.80 Typical High $10,232.93 | Facility | None | $426.58 | $1,737.80 | $10,232.93 |
Sentara Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $1,096.48 | Professional | None | $446.68 | $549.54 | $1,096.48 |
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 $316.23 Median $426.58 Typical High $831.76 | Professional | None | $316.23 | $426.58 | $831.76 |
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 $245.47 Median $257.04 Typical High $257.04 | Professional | 52 · Reduced service | $245.47 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $97.72 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 54 · Surgery only | $363.08 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $77.62 Typical High $77.62 | Professional | 55 · Aftercare only | $72.44 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $338.84 | $363.08 | $363.08 |
Where Virginia sits
The same service costs 5.1 times more in Washington, DC 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
DC $7,757MT $1,518
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.